Presented  by 
Loren  A.   Button,   D.   0. 


COLLEGE  OF  OSTEOPATHIC   PHYSICIANS 
AND  SURGEONS  •  LOS  ANGELES,  CALIFORNIA 


FROM    THE    LIBRARY 


PASADENA 


(JIOMCEOPATHY 

THE  SCIENCE  OF  THERAPEUTICS 


of 


ELUCIDATING       AND        ILLUSTRATING 


THE  PRINCIPLES  OF  HOMCEOPATHY. 


VBY     •' 

DUN 


CARROLL  DUNHAM,  A.M.,  M.D. 

GRADUATE    OF    THE    NEW- YORK    COLLEGE   OF  PHYSICIANS  AND   SURGEONS;   DEAN   OF   NEW-YORK 
HOMCEOPATHIC    COLLEGE;    PROFESSOR    OF    MATERIA    MEDICA;    PRESIDENT    OF    THE 
AMERICAN    INSTITUTE    OF     HOMCEOPATHY,  AND    OF   THE    WORLD'S    HOMCEO- 
PATHIC CONVENTION  HELD  AT  PHILADELPHIA,  1876;  AND  MEMBER 
OF     VARIOUS     AMERICAN     AND     FOREIGN     SOCIETIES. 


FOR    SALE   AT    ALL    HOMCEOPATHIC    PHARMACIES. 

PRINTED   FOR   THE   PROPRIETOR,  BY 

FRANCIS  HART  &  COMPANY,  No.  63   MURRAY  STREET,  NEW- YORK. 

1877. 


Entered,  according  to  Act  of  Congress,  in  the  year  1877, 

By  HARRIET  E.  K.  DUNHAM, 
In  the  Office  of  the  Librarian  of  Congress  at  Washington. 


P.    P.    WELLS,    M.  D. 

THE    HONORED   COLLEAGUE  AND    BELOVED    FRIEND   OF 
CARROLL    DUNHAM, 

THIS     VOLUME 
IS     RESPECTFULLY     DEDICATED. 


CONTENTS. 


ig62 
PEUTICS 


I... 


Date.         Page. 

I.  HOMOEOPATHY  THE  SCIENCE  OF  THERA- 


I 1864        99 


II.  ANTAGONISM    BETWEEN    HOMOEOPATHY  )  0,          , 

£ 1863        67 

AND  ALLOPATHY ) 

III.  RELATION   OF  PATHOLOGY  TO  THERA- 

PEUTICS   

IV.  PRIMARY  AND  SECONDARY  SYMPTOMS  OF  } 

DRUGS  AS  GUIDES   IN  DETERMINING  > 1875       115 

THE  DOSE ) 

V.  THE  DOSE  IN  DRUG- PROVING 1860  136 

VI.  ALTERNATION  OF  REMEDIES.     No.  i 1863  156 

VII.  ALTERNATION  OF  REMEDIES.     No.  2 1865  166 

VIII.  EDITORIAL  REMARKS  ON  ALTERNATION.    I...  1865  215 

IX.  EDITORIAL  REMARKS  ON  ALTERNATION.   II...  1865  223 

X.  THE  USE  OF  HIGH  POTENCIES  IN  THE  ) 

TREATMENT  OF  THE  SICK )          x     ^       22' 

XL  REPLY  TO  A  LETTER  ON  HIGH  POTENCIES..  .1864      257 
XII.  THE  QUESTION  OF  THE  DOSE 1864      267 

XIII.  THE  BASIS  OF  TREATMENT 1864       272 

XIV.  DIAGNOSIS  IN  HOMCEOPATHIC  PRACTICE,  ) 

WITH  COMPILATIONS  FROM  DR.  KAS-  > 1852       277 

PAR'S  LECTURES ) 

XV.  BELLADONNA— REPORTED  FROM  THE  GERMAN.  185 2       343 
XVI.  A  WEAK  SPOT  IN  OUR  MATERIA  MEDICA  ....  1870      347 


CONTENTS. 

Date.  Page. 

XVII.  DIRECTIONS  FOR  DRUG-PROVERS 1869  350 

XVIII.  PROVINGS  OF  LILIUM  TIGRINUM 1870  353 

XIX.    MUREX   PURPUREA 1864  367 

XX.  PLATINA — ADAPTED  FROM  THE  GERMAN 1853  387 

XXI.  REMARKS  ON  RUMEX  CRISPUS 1860  417 

XXII.  REMARKS  ON  GUAO 1863  423 

XXIII.  REMARKS  ON  SPIGELIA 1864  427 

XXIV.  DR.  HARLEY  ON  CONIUM  MACULATUM 1869  433 

XXV.  REMARKS  ON  CONIUM  MACULATUM  1870  443 

XXVI.  REMARKS  ON  MEZEREUM 1860  458 

XXVII.  DEAFNESS  CURED  BY  MEZEREUM 1858  462 

XXVIII.  CROUP  CURED  BY  BGENNINGHAUSEN'S  POWDERS.  1 860  467 

XXIX.  CHRONIC  DIARRHOEA  CURED  BY  A  SIN- 
GLE DOSE  OF  A  HIGH  POTENCY 


XXX.  PTERYGIUM  CRASSUM   CURED  BY  A  SIN- 
GLE DOSE  IN  A  HIGH  POTENCY 


SIN- >  Q, 

v 1860      470 

SIN-  ) 

j 1864      474 


XXXI.  PANAMA  FEVER  CURED  BY  ARSENICUM 1860  479 

XXXII.  CASE  CURED   BY  MAGNESIA  CARBONICA 1870  482 

XXXIII.  OVARIAN  TUMOR  CURED  BY  COLOCYNTH 1869  485 

XXXIV.  BAPTISIA  AS  A  HAIR- WASH 1868  488 

XXXV.  CHLORINE  IN  SPASMUS  GLOTTIDIS.    No.  i  ...1859  490 

XXXVI.  CHLORINE  IN  SPASMUS  GLOTTIDIS.    No.  2  ...1863  497 

XXXVII.  CHLORINE  IN  SPASMUS  GLOTTIDIS.    No.  3  ...1869  499 

XXXVIII.  ON  THE  ELIMINATION  THEORY   1866  502 

XXXIX.  CHOLERA   1865  504 


PREFACE. 


Since  the  death  of  Dr.  Carroll  Dunham,  a  desire 
has  been  expressed  by  many  of  his  colleagues  that 
his  writings  should  be  collected  in  book  form. 

The  present  volume  contains  such  as  most  directly 
express  his  views  on  the  cure  of  disease  by  drugs.  In 
their  arrangement  no  attention  has  been  paid  to  the 
order  of  time  in  which  they  were  written,  but  those 
on  the  principles  of  cure  have  been  placed  together, 
while  clinical  cases  illustrating  these  principles  have 
been  put  side  by  side;  and  so  great  is  the  unity  of 
thought  running  through  all,  that  it  has  not  been 
deemed  inappropriate  to  give  to  the  collection  the 
title  of  the  main  Essay. 

If,  forgetting  that  experience  and  reflection  will, 
as  years  go  by,  modify  the  opinions  of  every  thinker, 
any  reader  should  fancy  he  sees  contradictions  in 
these  papers,  he  is  referred  to  the  dates  at  which  they 
were  written1  and  he  will  discover  a  mind  ever 
progressive  and  hospitable  to  truth.  In  1864  the 
Author  writes:  "The  object  of  our  professional  life 
is  to  find  out  the  truth,  and  shape  our  practice  accord- 
ingly. Consistency  to  this  object  is  true  consistency, 

1  See  Table  of  Contents. 


PREFACE. 

while  consistency  to  any  form  of  opinion  or  doctrine 
which  may  at  one  time  have  been  supposed  to  be  the 
truth  and  proclaimed  by  us  as  such,  consistency  to 
such  opinion  merely  because  we  may  have  once 
publicly  uttered  it,  this  is  the  basest  and  most  ignoble 
bigotry  and  cowardice." 

These  papers  were  occasional,  unconnected  contri- 
butions to  periodicals,  addresses  delivered  at  the 
request  of  societies,  studies  of  remedies  or  some 
topic  connected  with  them,  and  clinical  cases.  Could 
they  have  been  revised  for  publication  as  a  book  by 
the  hand  that  wrote  them  they  might  be  more 
uniform  in  style  though  scarcely  more  connected  in 
thought.  To  the  Essay,  "Homoeopathy  the  Science 
of  Therapeutics,"  the  Author  devoted  more  than  usual 
time,  and  after  its  publication  in  the  A  merican  Homoe- 
opathic Review  it  was  issued  in  pamphlet  form. 
The  Dedicatory  Letter  which  then  accompanied  it 
is  here  given: 


To  M.  J.  CHAPMAN,  A.  M.,  Cantab.,  M.  D.,  Edin.,  London. 

Dear  Friend  and  Colleague  : 

If  I  show  presumption  in  honoring  these  pages  by  the  prefix  of  your 
name,  I  may  plead  in  extenuation  that  they  were  in  some  sort  written  at  your 
instigation. 

When  I  had  the  pleasure  of  personal  intercourse  with  you  (now  ten 
years  ago),  you  frequently  gave  me  the  following  advice :  "  Make  a  study  of 
Hygiene  in  its  relations  to  Medicine!  " 

One  could  not  proceed  far  in  such  a  study,  involving  as  it  does  the 
entire  philosophy  of  the  art  of  medicine,  without  being  compelled  to  meet  the 


PREFACE. 

following  questions,  which  have  perplexed,  and  still  perplex  and  divide  our 
school : 

Is  the  Homoeopathic  law  of  cure  sufficient  for  all  the  procedures  required 
in  the  treatment  of  the  sick  ? 

Or  is  it,  on  the  contrary,  only  a  part  of  a  still  broader  generalization  ? 

Or,  again,  are  there  other  laws  which  are  sometimes  to  be  our  guides  in 
Therapeutics?  and  if  so,  -when  are  they  to  be  used  ? 

Are  so-called  "  auxiliary  "  means  ever  requisite  ?  and  if  so,  how  does 
this  fact  affect  the  jurisdiction  of  the  law  of  cure  ? 

Those  who  give  only  a  limited  jurisdiction  to  the  Therapeutic  law  deduce 
their  faith  from  their  practice;  but  they  have  never  given  a  satisfactory  defini- 
tion of  the  boundaries  of  this  limited  jurisdiction. 

Those,  on  the  other  hand,  who  claim  exclusive  dominion  for  the  Thera- 
peutic law,  belie  their  faith  by  their  practice,  for  in  treating  the  sick  they  do,  as 
a  matter  of  fact,  avail  themselves  of  means  and  methods  which  are  not  author- 
ized by  this  law. 

Yet  neither  party  should  be  called  dishonest.  The  truth  is,  their  clin- 
ical instinct,  their  practical  sagacity,  has  outrun  their  philosophical  acuteness. 
Each  party  felt  its  way  nearly  to  the  true  ground,  but  neither  has  succeeded 
in  vindicating  its  claim  to  consistency  in  occupying  that  ground. 

The  result  has  been,  on  the  part  of  Homoeopathic  practitioners,  an  uncer- 
tainty of  their  true  position  in  relation  to  Old-school  medicine,  and,  consequently, 
a  degree  of  distrust  on  the  part  of  the  community. 

It  has  seemed  to  me  that  these  difficulties  might  be  removed,  and  the 
perplexing  questions  fairly  answered,  by  an  elaboration  of  the  nature  and  rela- 
tions of  the  sciences  of  Therapeutics  and  Hygiene,  which  should  show : 

That  Therapeutics  concerns  herself  only  with  the  discovery  and  selection 
of  an  individually  specific  remedy  for  each  individual  case  of  disease ;  which  is 
done  in  accordance  with  a  Therapeutic  law.  This  law  may  be  the  Homoeopathic 
formula,  or  it  may  be  some  broader  generalization ;  but  there  can  be  but  one 
law  of  this  kind ; 

That  the  province  of  Hygiene  is  to  discover  whatever  causes  may  have 
contributed  to  induce  or  perpetuate  the  diseased  condition,  and,  if  possible,  to 
remove  them ; 

That  Hygiene  alone  is  sufficient  to  restore  many  sick  persons  to  health, 
and  that  it  is  in  most  cases  an  indispensable  aid  to  Therapeutics;  that, 
therefore,  the  practicing  physician  is  at  one  and  the  same  time  Hygienist  and 
Therapeutist,  employing  often,  therefore,  for  the  same  case  both  specific  reme- 
dies and  various  "  auxiliaries ;  " 

That  in  so  far  as  Hygiene  is  concerned,  Homoeopaths  and  Allopaths 
occupy  common  ground, — the  philosophy  of  the  science  being  the  same  for 
both,  however  modified  and  shaded  in  practical  application  by  the  different 
Therapeutics  of  the  two  schools ; 

That  in  Therapeutics  alone — that  is,  in  the  discovery  and  selection  of 
the  individually  specific  remedy  for  each  individual  case  of  disease — do  we 
differ  radically  from  the  old  school  of  medicine, —  the  Allopaths  having,  in  fact, 
no  science  of  Therapeutics  whatever,  their  philosophy  of  cure  being  an  applica- 
tion of  the  principles  of  Hygiene  to  all  diseased  conditions. 


PREFACE. 

The  natural  sequence  of  a  study  of  the  philosophy  of  the  science  of 
Therapeutics  is  the  question  how  to  make  a  practical  application  of  it  in  the 
treatment  of  the  sick.  I  have  therefore  written  of  the  study  of  the  Materia 
Medica. 

Should  the  views  I  present  throw  any  light  upon  these  subjects,  I  shall 
have  to  thank  you  for  the  direction  given  to  my  studies.  Should  they  prove 
worthless,  you  will  join  me  in  hoping  for  a  sounder  fruit  from  the  labors  of  the 
next  decade. 

CARROLL  DUNHAM. 
New- York,  January,  1863. 


Should  the  reader  miss  in  the  present  volume 
some  Paper  he  had  expected  to  find  here,  it  is  prob- 
ably among  the  "  Lectures,"  reserved  for  future  pub- 
lication, or  among  the  Miscellanies  not  strictly 
belonging  to  the  present  book. 

Irvington-on-Hudson, 
June  25,  1877. 


HOMCEOPATHY    THE    SCIENCE    OF 
THERAPEUTICS. 

Homoeopathy  claims  to  be  "  The  Science  of  Therapeutics." 
This  claim  involves  the  assumption  that  prior  to  the  estab- 
lishment of  Homoeopathy  on  a  scientific  basis,  Therapeutics, 
as  a  science,  had  no  existence.  It  is  incumbent  on  Homoeop- 
athists  to  show  the  justice  of  this  assumption.  To  accom- 
plish this,  it  will  be  necessary  to  prove  that  such  a  science  is 
possible,  to  demonstrate  what  its  nature  and  conditions  must 
be,  and  to  show  that  medicine  hitherto  has  not  furnished  the 
means  for  the  construction  of  a  science  which  fulfills  these 
conditions. 

It  is  the  object  of  this  paper,  first,  to  discuss  the  nature 
and  conditions  of  the  only  possible  science  of  Therapeutics, 
to  show  that  these  conditions  are  not  fulfilled  by  what  is 
called  rational  medicine,  and  to  inquire  in  what  degree  they 
are  fulfilled  by  Homoeopathy.  And,  second,  to  examine  the 
methods  by  which  this  science  may  be  most  successfully  stud- 
ied and  made  subservient  to  the  practical  art  of  medicine. 

But  on  the  threshold  of  the  discussion  we  are  met  by  the 
necessity  of  defining  the  term  Therapeutics.  It  will  be 
found  that,  though  still  sufficiently  comprehensive,  it  is  used 
by  us  in  a  much  more  restricted  sense  than  that  which,  in 
popular  thought,  is  attached  to  it. 

Therapeutics  being  etymologically  the  science  of  curing 
diseases,  it  would  seem  to  comprise  the  entire  function  of 
the  physician.  It  is  evident,  however,  on  slight  considera- 
tion, that  the  medical  man  in  general  practice  brings  into 
requisition  too  great  a  variety  of  scientific  knowledge  to 
admit  of  comprehension  under  a  single  term.  To  show 
2 


2  HOMOEOPATHY 

how  great  this  variety  is  and  at  the  same  time  to  give  an 
indirect  definition  and  limitation  to  the  term  Therapeutics, 
let  us  analyze  a  series  of  cases  which  shall  not  be  ideal 
cases,  but  drawn  from  records  of  actual  practice. 

The  physician  is  called  in  haste  to  an  elderly  person  whose 
only  intelligible  complaint  is  of  great  anguish  in  the  prae- 
cordia,  and  which  appears  by  its  violence  to  endanger  his 
life.  If  he  be  in  immediate  danger  of  death,  the  state  of  his 
affairs  renders  it  desirable  that  his  family  should  be  informed 
of  the  fact  and  how  long  he  will  probably  live.  The  prog- 
nosis is  demanded,  and  its  correctness  is  a  matter  of  great 
importance.  The  medical  man  must  rely  on  his  knowledge 
of  Pathology1  for  a  conclusion  respecting  the  nature,  cause, 
and  probable  termination  of  the  disease.  With  this,  if  it  be 
a  fatal  case,  the  function  of  the  physician  ends.  Yet  how 
important  may  this  function  be  to  the  survivors  !  Here  is  as 
yet  no  question  of  Therapeutics.  It  is  merely  a  problem  in 
the  natural  history  of  disease,  which  the  physician  regards 
just  as  a  Naturalist  would  a  problem  in  Physics,  and  just  as 
if  the  idea  of  curing  disease  had  never  entered  the  head 
of  man. 

Again,  he  is  called  to  a  man  who  lies  in  an  epileptiform 
convulsion.  It  is  well  known  that  convulsions  may  arise 
from  the  most  various  proximate  causes.  They  may  result 
from  physical  irritation  of  the  nervous  centers  or  of  the 
extremities  of  the  nerve-filaments,  and  in  this  case  they 
will  cease  to  recur  so  soon  as  the  cause  of  irritation  is 
removed ;  or,  on  the  other  hand,  from  modifications  of  the 
vital  functions,  such  as  are  beyond  our  observation  and 
which  we  can  rectify  only  indirectly  by  the  action  of  specific 

1  Throughout  this  paper,  as  always  sues,  and  is  concrete.     A  corresponding 

by  its  author,  Pathology  is  used  with  a  distinction  obtains    between  Physiol- 

meaning  totally  distinct  from  that  of  ogy,  which  is  the  science  of  healthy 

Pathological  Anatomy.     The   former  processes and  functions,  and  Physiolog- 

is  the  science  of  morbid  processes  and  ical  Anatomy,  which  is  the  science  of 

functions,  and  is  abstract ;  the  latter  is  healthy  organs  and  tissues. 
the  science  of  morbid  organs  and  tis- 


THE   SCIENCE   OF  THERAPEUTICS.  3 

agents.  The  first  problem  before  the  physician  is  to  deter- 
mine by  a  study  of  the  phenomena  which  the  patient 
presents,  to  which  of  these  great  classes  the  case  before 
him  belongs.  It  is  indispensable  to  determine  this  question, 
because  the  treatment  of  the  case  must  depend  directly 
upon  it, —  in  the  former  case  it  may  be  mechanical  or  hygi- 
enic, in  the  latter  it  must  be  therapeutic.  He  determines, 
we  will  suppose,  in  the  case  before  us,  that  the  convulsion 
is  eccentric  in  its  origin  and  reflex  in  its  nature,  and  he  sees 
reason  for  suspecting  that  it  depends  on  some  cause  of  irri- 
tation in  a  nerve-filament  of  the  lower  extremity.  He  seeks, 
in  the  history  of  the  case,  and  by  a  physical  examination, 
for  this  irritating  cause,  and  discovers  that  the  patient  had, 
years  ago,  received  a  gunshot  wound  in  the  thigh.  There 
is  no  evidence  that  the  ball  was  ever  extracted.  A  close 
examination  seems  to  confirm  the  conjecture  that  it  still  lies 
imbedded  in  the  muscles  of  the  thigh.  An  exploratory 
operation  is  performed  and  the  ball  is  actually  found  lying 
upon  a  branch  of  the  sciatic  nerve.  It  is  removed  and  the 
patient  has  no  more  convulsions. l 

In  this  case  the  physician's  knowledge  of  pathology  ena- 
bled him  to  discriminate  between  the  varieties  of  convulsion 
as  to  their  proximate  causes;  his  acquaintance  with  physiol- 
ogy familiarized  him  with  the  phenomena  of  reflex-nervous 
action  and  enabled  him  to  detect  the  seat  of  the  irritation, 
and  finally  his  dexterity  in  practical  surgery  placed  it  in  his 
power  to  cure  the  patient  of  a  dreadful  malady.  But,  in  this 
case  from  beginning  to  end,  Therapeutics  was  not  called  into 
play. 

Again,  the  patient,  a  child  of  two  and  a  half  years,  is 
subject  to  epileptiform  convulsions,  which  occur  daily,  often 
twice  a  day.  They  first  appeared  when  the  child  was  four- 
teen months  old  and  soon  after  it  was  weaned.  They  are 
now  producing  a  very  sad  effect  upon  the  child's  intelligence. 

1  This  occurred  in  the  practice  of  a  distinguished  Surgeon  of  Massachusetts. 


4  HOMOEOPATHY 

The  same  question  of  proximate  cause,  which  the  last  case 
gave  rise  to,  suggests  itself,  first  of  all,  to  the  mind  of  the 
physician.  Careful  investigation  satisfies  him  that  there  is 
probably  a  constant  or  a  frequently  repeated  source  of  irri- 
tation in  the  digestive  apparatus.  What  so  probable  cause 
of  irritation  in  these  organs  as  improper  food  ?  The  question 
is  put  at  once,  "What  food  does  your  child  take?"  "Nothing 
whatever,  except  molasses-cake  and  milk."  "  How  do  you 
make  molasses- cake  ?"  "Three  cups  of  flour,  one  of  butter, 
one  of  milk,  one  of  molasses,  one  egg  and  a  tea-spoonful  of 
pearlash  ! "  "  Very  bad  for  your  child  !  Give  it  good  wheat 
bread  and  milk  and  nothing  else,  except  this  powder"  (of 
sugar  of  milk  as  a  placebo).  The  diet  of  the  child  is  thus 
reformed,  but  no  medicine  is  administered  and  the  case  is 
carefully  watched.  For  one  week  the  spasms  steadily  de- 
crease in  frequency  and  in  violence,  at  the  end  of  that  period 
they  cease  and  they  never  recur.1  Thus  an  abnormal  state 
of  things,  which  would  certainly  have  had  a  fatal  issue,  is 
rectified  by  the  application  of  a  knowledge  of  Physiology, 
Pathology  and  Hygiene ;  but  Therapeutics  has  no  part  in  it. 

Errors  in  diet  being  perhaps  the  most  numerous  of  all  of 
which  the  community  are  guilty,  instances  like  this  might  be 
accumulated  to  an  indefinite  extent.  It  is  clear  that  a  large 
part  of  a  medical  man's  practice  is  made  up  of  similar  cases, 
and  consequently  that  a  great  many  serious  cases  may  be 
successfully  treated  without  recourse  to  medicine — without 
the  aid  of  Therapeutics. 

Again,  a  patient  presents  herself  with  the  following  history: 
Within  three  months  she  has  rapidly  emaciated ;  her  sleep  is 
disturbed,  her  appetite  gone;  she  has  night-sweats;  is  prone 
to  diarrhoea ;  takes  frequent  deep  inspirations  which  fatigue 
her;  has  a  dry,  hacking  cough;  complains  of  extreme  weak- 
ness and  despondency.  A  careful  physical  examination  fails 
to  discover  organic  disease  of  thoracic  or  abdominal  organs, 

1  This  case  occurred  in  1857.  There       The  child  on  good  diet  is  healthy, 
h'as  been  no  recurrence  of  spasms. 


THE   SCIENCE   OF   THERAPEUTICS.  5 

nor  does  an  investigation  of  her  domestic  or  social  relations 
disclose  any  source  of  mental  or  affectional  anxiety.  The 
case  is  perplexing  as  to  its  inducing  cause,  and  the  physician 
inclines  to  ascribe  it  to  dynamic  causes  and  to  have  recourse 
primarily  to  specific  remedies  for  its  cure, — in  other  words, 
to  call  Therapeutics  to  his  aid, — when  he  discovers  that  the 
patient  is  nursing  an  infant  of  twelve  months.  Her  milk  is 
very  abundant,  but  a  microscopic  examination  shows  that  it 
is  extremely  deficient  in  oily  matter.  It  is  now  clear  that 
the  patient  is  unequal  to  the  drain  to  which  nursing  subjects 
her ;  she  is  suffering  from  consequent  anaemia.  It  is  ordered 
that  she  wean  her  babe  at  once.  As  soon  as  she  does  so, 
appetite  returns,  the  cough  and  night-sweats  disappear,  and 
strength  and  flesh  are  restored.  Now,  it  is  true  that,  in  such 
a  case,  the  decline  of  vigor  may  be  retarded,  and  after  wean- 
ing, the  restoration  may  be  accelerated  by  a  judicious  appli- 
cation of  Therapeutics ;  but  it  is  unquestionably  true  that 
Therapeutics  would  play  a  very  subordinate  part,  since  no 
administration  of  medicines  could  be  an  offset  to  the  drain 
which  is  exhausting  the  patient. 

In  cases  of  similar  exhaustion,  facial  Neuralgia  of  a  reg- 
ularly intermitting  character  sometimes  occurs  and  bids 
defiance  to  Therapeutics,  the  patient  meanwhile  declining 
rapidly  in  strength  and  health  until,  medicine  being  perhaps 
altogether  discarded,  but  the  patient  induced  to  wean  her 
infant  and  thereby  enabled  to  take  hearty  food,  strength 
and  flesh  return,  and  the  Neuralgic  pains  cease.  In  this 
case,  also,  the  restoration  may  be  accelerated  by  a  judicious 
recourse  to  Therapeutics,  but  here  too  Therapeutics  must  be 
subordinate  to  Hygiene. 

Once  more,  a  patient,  who  exhibits  signs  of  depraved 
nutrition,  complains  of  a  burning  pain  under  the  angle  of  the 
right  scapula,  with  a  tight  aching  across  ,the  back  between 
the  scapulas.  I  fear  that  repeated  prescriptions  will  fail  to 
relieve  this  burning  pain  unless  the  physician's  knowledge  of 
pathology  shall  have  suggested  to  him  that  the  symptoms 


6  HOMOEOPATHY 

result  ultimately  from  a  too  steady  use  of  the  needle  with 
too  rapid  a  motion,  and  unless  his  skill  in  Hygiene  shall  have 
enabled  him  so  to  order  her  mode  of  life  as  to  combine  due 
recreation  and  exercise  in  the  open  air  with  her  necessary 
labor.  Here,  as  in  other  cases,  Therapeutics  may  of  course 
come  in  and  play  a  subordinate  part. 

Finally,  a  patient  has  severe  darting  and  aching  in  the 
shin,  especially  at  evening,  with  coldness  of  the  extremity, 
and,  after  the  pain  has  lasted  an  hour,  great  sensibility  to 
touch,  relieved  by  warmth  and  by  continued  motion.  This 
case  has  been  treated  by  a  variety  of  Therapeutic  agents 
in  the  hands  of  several  learned  practitioners,  but  with  no 
success.  It  is  noticed  that  the  patient,  in  the  course  of  his 
business,  incurs  great  exposure  to  dampness  and  cold.  A 
woolen  stocking  is  advised,  and  he  enjoys  ever  after  adopting 
it  almost  complete  freedom  from  suffering,  and  which  is 
rendered  absolutely  complete  by  a  few  doses  of  Rhus  tox- 
icodendron.  It  must  be  remarked  that  this  remedy  had  been 
previously  administered  in  every  variety  of  potency  and  dose. 

Instances  of  a  similar  character  to  these  might  be  indefi- 
nitely multiplied.  They  go  to  show,  not  that  medicines  are 
vain  or  unnecessary,  but  that  very  many  cases  of  severe 
suffering  and  even  of  what  threatens  to  become  fatal  disease 
occur  in  general  practice,  which  call  for  and  are  successfully 
met  by  the  application  of  scientific  knowledge  apart  from 
Therapeutics.  They  show  that  an  extensive  and  thorough 
knowledge  of  Physiology,  Pathology  and  Hygiene  are  indis- 
pensable to  the  physician  to  enable  him  to  make  that  prelim- 
inary analysis  of  a  case  by  which  he  will  determine  under 
what  category  the  case  belongs,  and  whether  or  not  it  calls 
for  treatment  by  medicines  in  part  or  entirely — whether  it 
comes  under  the  domain  of  Therapeutics  or  not.  They  show, 
moreover,  that,  inasmuch  as  Homoeopathy  directly  involves 
the  science  of  Therapeutics  alone,  there  is  a  large  field  which 
is  occupied  and  cultivated  in  common  by  Homceopathists 
and  practitioners  of  the  Old  School.  They  serve  in  part,  also, 


THE   SCIENCE   OF   THERAPEUTICS.  / 

to  mark  the  boundaries  of  that  field  in  which  "  Rational 
Medicine  "  may  legitimately  claim  dominion,  in  which  her 
chief  honors  have  been  won,  and  in  which  the  great  advances 
which  she  boasts  of  having  made  in  the  treatment  of  diseases 
within  the  last  thirty  years  have  almost  exclusively  been 
achieved — the  field  of  Hygiene.  It  is  fitting  that  we  study 
for  a  few  moments  this  territory  of  Hygiene,  which  is  com- 
mon to  practitioners  of  all  the  varieties  of  Therapeutic  faith 
and  practice, —  this  science  on  which,  together  with  the  sci- 
ence of  Therapeutics,  the  whole  art  of  medicine  is  based  — 
its  subjects,  limits,  conditions,  and  mode  of  growth. 

THE  NATURE  AND  LIMITS  OF  THE  SCIENCES  OF 
HYGIENE  AND  THERAPEUTICS.  —  The  living  organism 
possesses  a  susceptibility  to  the  action  of  certain  general 
stimuli,  such  as  light,  heat,  electricity,  aliment,  atmospheric 
air,  etc.  The  action  and  reaction  of  these  stimuli  and  this 
susceptibility  are  the  conditions  of  life.  So  long  as  they  act 
upon  it  in  a  due  relative  proportion,  as  regards  intensity  and 
quantity,  the  equilibrium  of  the  functions  is  preserved  and 
the  organism  continues  in  healthy  action.  The  absolute 
withdrawal  of  one  of  the  stimuli  for  any  considerable  length 
of  time  results  in  death.  A  disturbance  of  their  due  propor- 
tion, in  respect  of  intensity  or  quantity,  produces  an  abnor- 
mal performance  of  function  in  the  organism — a  deviation 
from  health — disease.  But  these  stimuli  are  continually 
varying  in  proportion,  or,  in  other  words,  the  relative  suscep- 
tibility of  the  organism  is  continually  changing.  Why  does 
not  disease  constantly  exist  ?  Because  the  organism  is 
endowed  with  either  a  faculty  of  provisionally  supplementing 
to  a  limited  extent  one  stimulus  by  another,  or  with  a  kind 
of  elasticity, —  a  power  of  enduring  for  a  certain  time  a 
disturbance  of  the  equilibrium  of  these  stimuli,  and  of 
rebounding  to  a  normal  performance  of  functions  again  so 
soon  as  the  natural  proportion  of  the  stimuli  is  restored  or 
the  deficiency  made  up.  In  this  respect,  the  living  organism 


8  HOMCEOPATHY 

differs  from  an  inorganic  machine,  which  cannot,  in  the 
nature  of  things,  possess  any  power  to  endure  a  disturbance 
of  that  equilibrium  of  forces  which  is  the  condition  of  its 
normal  working  without  a  disorganization  from  which  it  has 
no  inherent  power  to  recover. 

But,  in  the  organism  this  elasticity  has  its  limits.  This 
"vis  medicatrix  natura"  is  not  inexhaustible.  If  the  due 
proportion  of  the  stimuli  remain  too  long  disturbed,  the 
functions  of  the  organism  become  permanently  deranged  — 
at  least,  to  such  an  extent,  that  no  restoration  of  the  balance 
of  the  stimuli  will  cause  a  return  to  their  normal  perform- 
ance. The  functions  are  and  remain  deranged — disease 
has  occurred  ;  or,  if  we  choose  to  call  every  deviation  from  a 
state  of  equilibrium  disease,  then  we  may  say  that  now 
disease  ensues  which  has  no  tendency  to  revert  to  health 
without  the  intervention  of  some  extraneous  influence  foreign 
to  the  organism  and  different  from  the  general  stimuli 
aforesaid.  Since,  then,  the  general  stimuli  will  not  bring 
back  the  organism  to  a  healthy  action,  a  new  element 
must  be  sought  for  and  introduced,  the  action  of  which 
upon  the  susceptibilities  of  the  organism  may  cause  a  restora- 
tion to  health.  This  new  element  will  be  a  special  stimu- 
lus. Being  foreign  to  the  organism  and  different  from  the 
general  stimuli,  not  only  must  it  act  upon  susceptibilities 
in  the  organism  which  the  latter  do  not  awaken,  but  the 
formula  which  shall  express  its  relations  to  those  suscepti- 
bilities, and  which  shall  furnish  the  rule  for  its  employment, 
can  never  be  discovered  by  a  study  of  Physiology,  for  Physi- 
ology concerns  herself  with  the  relations  of  the  general 
stimuli  aforesaid  and  the  general  susceptibilities  of  the 
organism.  This  formula  of  the  relations  of  special  stimuli 
and  special  susceptibilities  can  be  discovered  only  by  the 
application  of  induction  to  a  multitude  of  instances  of  the 
action  and  reaction  of  such  stimuli  and  susceptibilities,  and 
confirmed  by  subsequent  deductive  verifications.  This  for- 
mula will  constitute  an  empirical  law,  which  will  be  the  law 


THE   SCIENCE   OF   THERAPEUTICS.  Cj 

or  fundamental  principle  of  Therapeutics.  For  the  applica- 
tion of  special  stimuli  to  the  diseased  organism  is  the  domain 
of  the  science  of  Therapeutics,  while  all  that  concerns  the 
restoration  and  maintenance  of  a  proper  equilibrium  of  the 
general  stimuli  appertains  to  the  science  of  Hygiene. 

These  propositions  may  be  more  intelligible  if  illustrated 
by  a  reference  to  daily  experience.  A  healthy  man  is  ex- 
posed to  an  unusual  degree  of  cold ;  in  other  words,  there 
exists  for  him  a  deficit  of  heat — one  of  the  general  stimuli 
which  are  necessary  to  maintain  life.  Nature  has  anticipated 
variations  in  the  supply  of  this  stimulus  from  external 
sources  by  her  liberal  provisions  of  calorific  apparatus  within 
the  organism.  Despite  the  operation  of  this  provision,  he 
is  chilled  and  suffers  from  rigors,  etc.  After  a  time  he  seeks 
shelter,  sits  by  a  fire,  takes  a  warm  drink ;  in  other  words, 
receives  from  external  sources  an  excess  of  that  general 
stimulus  from  deficiency  of  which  he  has  been  suffering.  His 
functions  resume  their  normal  play.  He  is  in  perfect  health. 
Here  the  equilibrium  of  the  functions  has  been  disturbed  and 
(if  we  use  terms  with  extreme  rigor)  disease  has  been  pro- 
duced, but  not  to  a  degree  beyond  the  provisions  of  the  vis- 
medicatrix  natures — the  natural  tendency  to  a  restoration  of 
the  balance  of  the  functions.  The  case  was  treated  upon 
"  general  principles  "  in  accordance  with  the  maxim  causa  sub- 
lata  tollittir  effectus.  And  this  maxim  represents,  in  fact, 
the  great  law  of  Hygiene,  viz.  :  that  it  be  ascertained  what 
stimulus  has  been  deficient  or  excessive  in  quantity  or 
abnormal  in  quality,  and  that  the  equilibrium  of  the  stimuli 
be  restored. 

But  let  us  suppose  that  the  same  man  has  again  been 
exposed  to  cold,  perhaps  to  a  greater  degree.  He  seeks 
shelter  and  essays  to  restore  the  lost  heat,  but  without  avail. 
Despite  the  fire  and  warm  drinks,  the  rigors  continue  and 
are  succeeded  by  fever  and  quickened  respiration,  cough, 
etc.,  or  by  rheumatic  pains,  redness  and  swelling,  etc.  Why 
this  difference  between  the  cases  ?  This  case  too  has  been 


IO  HOMCEOPATHY 

treated  on  "  general  principles."  The  cause  has  been  re- 
moved, why  has  not  the  effect  ceased  ?  The  equilibrium  of 
the  general  stimuli  has  been  restored  and  the  loss  made 
good;  why  is  not  the  normal  equilibrium  of  the  functions 
re-established  ? 

The  normal  proportion  of  the  general  stimuli,  it  is  true, 
has  been  restored,  but  during  the  disturbance  a  new  element 
had  been  introduced  into  the  problem.  The  organism  had 
suffered  a  dynamic  and  then  an  organic  change.  The  func- 
tions are  permanently  modified.  The  general  stimuli  may 
henceforth  be  balanced  never  so  carefully,  and  in  strictest 
accordance  with  the  rules  of  Hygiene ;  the  organism  will  not 
respond. 

Its  functions  are  performed  after  a  new  fashion.  The 
organs  are  not  susceptible  to  the  wonted  stimuli  applied 
according  to  the  laws  of  Hygiene.  The  organism  has  passed 
from  a  state  of  health  into  one  of  permanent  disease.  The 
general  stimuli  which,  modified  and  balanced  under  the  laws 
of  Hygiene,  sufficed  to  steady  it  as  it  rocked  and  swayed  in 
its  rapid  course  along  the  rough  and  crooked  railway  of  life, 
will  no  longer  answer  the  purpose,  for  in  its  rocking  it  has 
run  off  the  track,  and  is  now  bumping  along  over  the  cross- 
ties,  making  headway,  it  is  true,  but  toward  its  own  destruc- 
tion. It  needs  now  the  intervention  of  some  new  agent 
acting  under  a  new  law — of  a  jack-screw  and  levers  operated 
by  forces  from  without — to  re-instate  it  on  the  road  of 
healthy  action.  The  wonted  general  stimuli  under  the  laws 
of  Hygiene  being  insufficient,  new  stimuli  of  a  special  charac- 
ter must  be  applied  according  to  a  neiv  law.  This  new  law, 
whatever  it  be,  is  the  Therapeutic  law,  and  these  new  stimuli 
are  Therapeutic  agents,  and  the  study  of  the  law  and  of  the 
agents  constitutes  the  science  of  Therapeutics. 

Having  thus  marked  out  its  limits,  we  have  next  to 
inquire  what  the  nature  of  any  possible  science  of  Thera- 
peutics must  be.  Its  subject  is  the  modified  functions  and 
organs  of  the  body.  Its  agents  are  special  stimuli  drawn 


THE   SCIENCE   OF  THERAPEUTICS.  II 

from  whatever  region  of  the  external  world.  By  what  sort 
of  a  formula  can  these  agents  be  applied  to  that  subject  ? 
Can  the  Therapeutist  act  on  "  general  principles "  as  the 
Hygienist  does  ?  Can  he  act  on  the  maxim  causa  sublata 
tollitur  effectus?  Obviously  he  cannot.  In  so  far  as  the 
cause  of  disease  can  be  discovered  in  external  influences,  the 
treatment  falls  within  the  limits  of  the  science  of  Hygiene  as 
already  discussed.  In  so  far,  however,  as  the  cause  of 
disease  is  identical  with  the  essential  cause  of  the  modifica- 
tion of  function  or  organ  which  we  recognize  as  the  disease, 
it  can  never  be  discovered,  for  it  is  the  same,  in  its  nature,  as 
the  cause  of  healthy  functional  or  organic  action ;  in  other 
words,  it  is  life  itself,  the  nature  of  which,  as  of  every  first 
cause,  is  inscrutable.  It  being  impossible  then  to  ascertain 
the  essential  cause  of  disease,  and  to  apply  a  remedy  accord- 
ing to  the  rational  method — as  the  Hygienist  does — the 
Therapeutist  is  necessarily  thrown  back  from  an  attempt  to 
investigate  first  causes,  to  the  study  of  phenomena  and  to  the 
adoption  of  the  empirical  method.  In  accordance  with  this 
method,  the  subject  of  his  researches  will  be  respectively  the 
phenomena  manifested  by  the  patient,  and  the  phenomena 
produced  by  the  special  stimulus,  and  his  endeavor  must  be 
to  discover  a  general  formula  which  shall  express  a  constant 
relation  between  these  two  series  of  phenomena  and  shall 
serve  as  the  Therapeutic  law.  In  thus  acting,  and  upon  this 
method,  he  will  do  precisely  what  the  student  of  every 
branch  of  Natural  Science  does  and  has  done.  For  in  his 
inability  to  find  out  the  essential  cause  of  the  phenomena 
that  form  the  subject  of  his  study,  the  physician  finds  himself 
in  the  very  same  predicament  as  the  Naturalist  who  likewise 
has  vainly  sought  to  discover  the  essential  causes  of  the  phe- 
nomena of  gravitation,  of  light,  of  chemical  action,  and  of  elec- 
tricity. As  the  physician  is  unable  to  discover  the  essential 
nature  of  life  and  organism,  whether  normal  or  modified,  to 
ascertain  the  cause  of  health  or  of  disease,  and  is  therefore 
unable  to  treat  disease  upon  the  principle  "  tolle  causam  " 


12  HOMCEOPATHY 

(except  in  matters  of  Hygiene,  as  before  stated),  or  "  on 
general  principles;"  so  the  Naturalist  has  been  compelled  to 
abandon  the  rational  method,  such  as  Aristotle  proposed  and 
philosophers  elaborated  up  to  the  time  of  Bacon  and  New- 
ton, and  to  adopt  an  empirical  method  in  which  the  funda- 
mental principle  is  an  empirical  law  or  generalization 
expressing  the  relation  between  two  series  of  phenomena. 
The  science  of  Physics,  for  example,  consists  of  the  phenom- 
ena respectively  of  two  bodies,  or  series  of  bodies,  so  far 
as  density  and  volume  are  concerned,  and  of  the  law  of 
gravitation  which  expresses  the  relation  between  these 
respective  phenomena. 

The  Therapeutist,  then,  abandoning  all  idea  of  construct- 
ing a  science  of  Therapeutics  on  the  rational  method,  must 
have  recourse  to  the  empirical,  as  the  elaborators  of  other 
natural  sciences  have  done.  The  elements  of  his  science  will 
be  as  follows :  He  has  to  deal  with  a  subject  known  by  its 
phenomena — the  sick  body,  with  an  agent  known  also  by 
its  phenomena  —  the  drug;  and  with  a  law  which  shall  tell 
how  to  apply  the  agent  to  the  subject  for  the  accomplish- 
ment of  a  cure, —  a  law  which  shall  express  the  general 
relation  between  the  drug  and  the  morbid  organism. 

The  following  tabular  statement  will  show  more  clearly 
the  nature  of  Therapeutics  as  a  science,  and  its  harmony 
with  other  Natural  Sciences;  for  every  Inductive  Natural 
Science  (except  those  of  classification)  consists  elementarily 
of  two  series  of  independent  phenomena,  connected  by  the 
formula  of  their  general  relation  : 

THERAPEUTICS. 

Morbid  Functions  &  Organs,  \  (  Toxic  Functions  &  Organs, 
Or,  Pathology  and   Patho-  (  Therapeutic       ^  Or,  Pathogenesis  and  Patho- 
logical Anatomy,                  f  Law.             y      genetic  Anatomy, 
Or,  Sick-Phenomena,             J  \  Or,  Drug- Phenomena. 

PHYSICS. 

Phenomena     of    the    Sun,  i  T        of  ^  Phenomena  of  the   Earth, 

as  regards  Volume   and  >         Attraction  1      as   regar(*s  Volume   and 

Density,  )  (      Density. 


THE    SCIENCE   OF   THERAPEUTICS.  13 


CHEMISTRY. 

)  Law  of  Chemical  ( 

Properties  of  Potassa,  >  Affinity  and  Defi-  <  Properties  of  Sulphuric  acid. 

)    nite  Proportion.  ( 

OPTICS. 

Properties  of  the  Luminous  f         -^.^  °.      ^  ]  Properties  of  the  light-re- 

Body,  ^  L}ght  ^      ceivingbody. 


Though  thus  simple  in  theory,  Therapeutics  is  in  reality 
the  most  complex  of  all  the  natural  sciences.  Each  of  the 
classes  of  phenomena  requires  for  its  study  the  aid  of  several 
auxiliary  sciences.  Thus,  in  order  to  know  thoroughly  the 
phenomena  of  disease,  we  must  call  to  our  aid  Anatomy  and 
Physiology,  Chemistry,  Physics  and  Psychology.  To  know 
and  understand  thoroughly  the  phenomena  of  artificial  dis- 
ease or  pathogenesy,  we  must  avail  ourselves  of  the  same 
auxiliary  sciences.  The  more  imperfect  our  knowledge  of 
these  sciences,  the  less  complete  will  be  our  acquaintance 
respectively  with  the  phenomena  of  Pathology  and  Patho- 
genesy, and  the  converse.  But,  however  complete  or  partial 
may  be  our  knowledge  of  these  two  classes  of  phenomena, 
the  relation  between  them,  as  known,  remains  the  same,  and 
is  always  expressed  by  the  therapeutic  law.  The  same  is 
true  of  Physics  and  of  all  the  natural  sciences.  Our  knowl- 
edge of  the  physical  properties  of  matter  is  continually 
increasing.  The  more  complete  it  is,  the  more  exact  will  be 
our  application  of  the  law  of  attraction.  But  complete  or 
incomplete,  the  law  is  equally  applicable,  and  pro  tanto 
available. 

THE  CONDITIONS  OF  A  SCIENCE  OF  THERAPEUTICS. — 
We  come  now  to  consider  two  conditions  to  which  every 
natural  science  must  be  subject,  and  which  may  therefore 
serve  as  tests  of  its  fitness  to  be  regarded  as  a  "  Science." 
The  first  of  these  is  a  capability  of  infinite  progress  in  each 
of  its  elements  without  detriment  to  its  integrity  as  a  whole. 


14  HOMCEOPATHY 

We  have  already  seen  that  the  science  of  Physics  is  capa- 
ble of  such  progress  in  the  phenomena  with  which  it  deals. 
Our  knowledge  of  these  phenomena  is  continually  growing 
more  comprehensive  and  more  minute,  and  new  elements  of 
knowledge  are  continually  coming  into  our  possession  with 
regard  to  them  ;  yet  their  relation  to  each  other  through 
the  law  of  attraction  remains  the  same,  and  the  science,  in 
its  nature  and  structure,  receives  no  modification.  But  not 
only  are  its  subjects,  the  phenomena,  capable  of  progress  ; 
the  law  itself  may  advance  from  a  minor  to  a  grander  gener- 
alization, as  it  was  advanced,  step  by  step,  by  Newton,  and 
still  without  destruction  of  the  previous  steps.  The  same  is 
true  of  Chemistry.  As  our  means  of  investigation  become 
more  exact  and  extensive,  our  knowledge  of  the  properties 
of  bodies  increases ;  yet  the  law  of  Chemical  Affinity  in 
definite  proportions  remains  undisturbed.  Furthermore,  this 
law  itself  becomes  the  subject  of  more  extended  generaliza- 
tions. The  law  as  established  by  Black  and  Cavendish  was 
suspended,  yet  not  overthrown  (nor  the  science  disturbed) 
by  the  wider  generalization  of  Dalton's  Atomic  Theory ; 
and  this  again  forms  but  a  part  of  Faraday's  Theory  of  the 
Identity  of  Chemical  Affinity  and  Electrical  Attraction,  and 
amid  all  these  revolutions  in  abstract  theory,  the  science  of 
practical  Chemistry  has  held  an  even  way. 

In  the  science  of  Optics,  again,  the  phenomena  of  the 
luminous  body  and  those  of  the  light-receiving  body  are 
connected  by  the  law  of  the  transmission  and  diffusion  of 
light.  This  structure  of  the  science  and  all  that  is  based 
upon  it  rests  undisturbed  through  all  the  mighty  changes 
which  recent  discoveries  have  wrought  in  our  knowledge  of 
Optics — enriched  but  not  revolutionized  by  them.  But 
while  the  progress  of  the  science  has  been  thus  rapid  and 
uninterrupted,  philosophers  have  been  and  remain  at  vari- 
ance respecting  the  very  nature  of  light  and  its  mode  of 
propagation.  One  school  holds  to  the  theory  of  emission, 
another  to  the  undulatory  theory.  Now,  let  us  suppose 


THE   SCIENCE   OF  THERAPEUTICS.  15 

that  the  science  of  Optics,  instead  of  being  based  upon  an 
empirical  law,  the  result  of  induction,  and  which  expresses 
the  relation  between  two  series  of  observed  phenomena,  had 
been  based  upon  a  theory  of  the  essential  nature  of  light  and 
its  mode  of  transmission.  It  is  very  evident  that  the  whole 
structure  that  might  be  built  upon  the  theory  of  emission 
would  be  toppled  over  so  soon  as  the  theory  of  undulation 
should  be  established.  And  should  subsequent  observation 
again  lend  .  countenance  to  the  theory  of  emission,  down 
would  go,  of  necessity,  the  whole  science  as  built  upon  the 
undulatory  theory.  And  thus,  inasmuch  as  experience  and 
sound  philosophy  render  it  tolerably  certain  that  we  shall 
never  attain  absolute  knowledge  on  this  subject,  we  should 
have,  through  all  time,  an  endless  succession  of  half-com- 
pleted fabrics  and  hopeless  ruins,  but  no  infinitely  progres- 
sive science  of  Optics. 

This  furnishes  an  exact  illustration  of  what  would  be  the 
history  of  any  science  of  Therapeutics  not  constructed  upon 
the  empirical  plan  already  elaborated.  Let  us  suppose  that 
instead  of  taking  as  the  subject  of  action,  the  phenomena  of 
disease  as  derived  from  observation  with  all  the  aid  which 
auxiliary  sciences  can  afford,  we  should  take  a  theory  of 
disease,  —  its  essential  nature  and  mode  of  development, — and 
upon  ttiis  theory  should  construct  a  science.  All  would 
go  well,  until  facts  should  show  that  our  theory  was  insuf- 
ficient and  untenable  (and  facts  would  show  this,  since,  as 
we  have  already  seen,  the  essential  nature  of  disease  is 
inscrutable).  Now  our  whole  structure  would  be  over- 
thrown, nor  would  the  fragments  even  be  available  for  the 
construction  of  another  science  or  another  theory,  for  they 
would  consist  of  observations  made,  not  independently,  but 
on  the  basis  of  a  theory  and  with  reference  to  it.  There 
could  thus  be  no  possibility  of  steady,  uninterrupted,  infinite 
progress  in  the  science.  There  would  be  a  succession  of 
dynasties  of  theory,  each  based  on  the  overthrow  of  a 
former,  and  each  in  turn  demolished  by  its  successor.  That 


1 6  HOMOEOPATHY 

this  is  the  history  of  the  Therapeutics  of  the  Old  School 
of  medicine  up  to  the  present  day  is  admitted  by  common 
consent.  It  will  continue  until  attempts  to  erect  a  rational 
science  of  Therapeutics  upon  a  theory  of  disease,  confound- 
ing the  law  with  the  phenomena,  shall  give  place  to  the 
construction  of  an  empirical  inductive  science. 

"What  then  !  "  it  may  be  asked,  "shall  we  not  investigate 
and  theorize  upon  the  nature  of  disease  in  general,  or  of 
diseases  in  particular  ? "  By  all  means  investigate  and 
theorize,  just  as  physicists  do  upon  the  nature,  properties 
and  transmission  of  light — but  do  it  as  studying  the  science 
of  Pathology,  not  that  of  Therapeutics — and  avoid  most 
carefully,  making  these  theories  which  can  be  at  best  no 
more  than  temporary  aids  to  the  observation  and  grouping 
of  phenomena,  the  basis  of  a  practical  science.  If,  however, 
they  throw  light  on  the  study  of  phenomena,  render  our 
observations  of  them  more  keen  and  more  exact,  or  afford 
us  connecting  links  between  isolated  groups  of  phenomena, — 
and  they  will  do  all  this, — they  will  render  valuable  indirect 
aid  to  the  science  of  Therapeutics,  just  as  similar  investiga- 
tions of  light  have  advanced  our  knowledge  of  Optics. 

A  second  condition  or  test  of  a  natural  science,  and 
therefore  of  any  proposed  science  of  Therapeutics,  is  that  it 
shall  provide  for  the  prediction  of  future  events  within  its 
own  domain.  It  must  furnish  means  of  prevision.  The 
problem  must  be  as  follows :  Given  the  law  and  one  series 
of  phenomena,  to  state  the  corresponding  series  of  phenom- 
ena on  the  other  side.  This  condition  is  admirably  stated 
by  Whewell :  "  Men  cannot  help  believing  that  the  laws  laid 
down  by  discoverers  must  be  in  a  great  measure  identical 
with  the  real  laws  of  nature,  when  the  discoverers  thus 
determine  effects  beforehand,  in  the  same  manner  in  which 
nature  herself  determines  them  when  the  occasion  occurs. 
Those  who  can  do  this  must  to  a  great  extent  have  detected 
nature's  secret — must  have  fixed  upon  the  conditions  to 
which  she  attends  and  must  have  seized  the  rules  by  which 


THE   SCIENCE   OF  THERAPEUTICS.  \J 

she  applies  them.  Such  a  coincidence  of  untried  facts  with 
speculative  assertions  cannot  be  the  work  of  chance,  but 
implies  some  large  portion  of  truth  in  the  principles  on 
which  the  reasoning  is  founded.  To  trace  order  and  law  in 
that  which  has  been  observed,  may  be  considered  as  inter- 
preting what  nature  has  written  down  for  us  and  will 
commonly  prove  that  we  understand  her  alphabet.  But  to 
predict  what  has  not  been  observed  is  to  attempt  ourselves  to 
use  the  legislative  phrases  of  nature  ;  and  when  she  responds 
plainly  and  precisely  to  that  which  we  thus  utter,  we  cannot 
but  suppose  that  we  have  in  a  great  measure  made  ourselves 
masters  of  the  meaning  and  structure  of  her  language.  The 
prediction  of  results  even  of  the  same  kind  as  those  which 
have  been  observed,  in  new  cases,  is  a  proof  of  real  success 
in  our  inductive  processes."  1 

The  discovery  of  the  planet  Neptune  by  Leverrier  and 
Adams  affords  an  instance  of  this  prevision,  in  Astronomy, 
the  details  of  which  are  familiar  to  all.  The  problem  was : 
Given  the  law  of  attraction  and  a  series  of  phenomena,  con- 
sisting of  certain  unexplained  perturbations  of  Jupiter — to 
find  the  other  and  corresponding  series  of  phenomena.  The 
calculations  were  made ;  the  resulting  phenomena  were 
stated  to  be  those  of  an  undiscovered  planet  of  a  given  size 
and  orbit  and  a  definite  location,  the  existence  of  which  was 
accordingly  affirmed  and  its  discovery  predicted.  Physical 
investigation  confirmed  the  induction. 

This  condition  applies  to  all  natural  sciences,  and  of  course 
to  Therapeutics.  The  problem  would  be :  Given  the  Thera- 
peutic law  and  a  certain  series  of  phenomena  of  natural  or 
drug  disease,  to  find  the  corresponding  series  of  phenomena 
of  drug  or  natural  disease. 

DOES  "  RATIONAL  MEDICINE  "  FULFILL  THESE  CONDI- 
TIONS?— This  being  the  nature  and  these  the  conditions  and 

1  Whewell,  Philosophy  of  the  Inductive  Sciences,  vol.  ii.,  pp.  64,  65. 

3 


1 8  HOMCEOPATHY 

tests  of  the  only  possible  science  of  Therapeutics,  we  come 
now  to  inquire  whether  the  Old- School  Therapeutics  are  of 
this  nature  or  will  sustain  these  tests.  The  works  of  the 
foremost  men  of  the  Old  School  abound  in  admissions  of  their 
lack  of  a  therapeutic  law  and  of  the  chaotic  state  of  their 
practice.1  But  the  efforts  of  these  men  to  remedy  this  sad 
state  of  things  show  a  constant  misapprehension  of  the  philos- 
ophy of  the  science  they  are  striving  to  construct. 

We  may  divide  Old-School  Therapeutics  into  two  methods. 
The  one  bases  the  plan  of  cure  upon  a  theory  of  the  nature 
of  the  disease,2  endeavors  so  to  study  the  pathology  of  the 
disease  as  to  form  a  sound  hypothesis  of  its  modus  operandi 
and  then  essays  the  cure  upon  "  general  principles."  It 
undertakes,  in  fact,  to  act  in  Therapeutics  upon  what  we  have 
seen  to  be  the  true  method  in  Hygiene.  There  are  three 
objections  to  this  method,  any  of  which  would  be  conclusive 
were  there  not  a  prior  difficulty  in  the  simple  impossibility  of 
arriving  at  a  knowledge  of  the  nature  of  the  disease,  which 
is  modified  life,  A  simple  example  will  show  this  impos- 
sibility. In  Pneumonia  the  blood  contains  an  excess  of 
fibrine.  How  happens  this  ?  Why,  either  the  elimination 
of  fibrine  has  been  retarded  or  its  fabrication  has  been  accel- 
erated. What  are  the  agents  of  these  respective  processes  ? 
Cells — which  are  essentially  similar  in  all  parts  of  the  body 
— and  yet  whose  structureless  walls  possess  the  power  of 
separating  from  the  circumambient  fluids  the  most  diverse 
substances  in  different  organs — nay,  even  of  manufacturing 
new  substances.  Now,  until  we  can  learn  the  secret  of  this 
mysterious  power  of  the  cell  wall,  which  begins  and  ends 
with  life,  which  we  can  neither  comprehend  nor  imitate  nor 
simulate,  we  shall  not  arrive  at  an  understanding  of  the 
nature  of  any  disease. 

1  See  Forbes,  Bennett,  Tod,  Holmes      says  :  "  In  these  wards,  by  those  bed- 
and  others.  sides,  have  you  seen  the  patient  ap- 

2  Thus  Prof.  Geo.  T.  Elliott  in  his      plication  of  the   searching  analytical 
recent  Valedictory  to  the  Graduating      laws  by  which  we  seek  to  discover  the 
class   at   Bellevue    College    Hospital      essentiality  of  disease." 


THE   SCIENCE   OF  THERAPEUTICS.  19 

Of  the  other  objections  to  this  method  the  first  two  are 
somewhat  paradoxical.  The  method  constitutes  rather  a 
congeries  of  sciences  of  Therapeutics,  based  on  theories  of 
isolated  groups  or  types  of  disease,  than  a  single,  all-embrac- 
ing science  founded  on  one  comprehensive  theory  of  disease. 
Hence,  a  new  science  must  be  formed  for  every  new  type. 
It  is  too  special.  On  the  other  hand,  it  is  too  general  to 
embrace  all  the  phenomena  of  each  individual  case.  For 
observation  shows  incontestably  that  so  great  are  the  vari- 
eties of  temperament  and  relative  organization  and  condition 
among  men,  that  no  two  cases  of  the  same  disease,  so  to 
speak,  are  exactly  alike. 

Such  a  Therapeutics  must  be  necessarily  based  on  a 
theory  which  is  a  generalization,  and  which  therefore  over- 
looks those  phenomena  of  a  given  case  which  are  peculiar  to 
the  individual  patient  and  takes  cognizance  only  of  those 
phenomena  which  are  common  to  a  great  number  of  cases. 
Now,  a  method  which  requires  such  generalization  and  makes 
no  provision  for  the  strictest  individualization  is  radically 
vicious. 

The  eye  of  science  regards  natural  phenomena  with  the 
most  absolute  impartiality.  In  her  view  there  are  no  trifles, 
no  events,  subjective  or  objective,  which  are  "irrelevant" 
and  "  of  no  moment."  A  method  of  Therapeutics,  however, 
which  selects  a  few  symptoms,  calls  them  pathognomonic  of 
Pneumonia,  constructs  upon  them  a  theory  of  the  disease, 
and  from  this  deduces  a  mode  of  cure,  must  disregard  many 
phenomena  of  every  individual  case.  It  arbitrarily  pro- 
nounces them  "  accidental  " — but  Nature  knows  no  accidents. 

So  far  is  this  method  from  meeting  the  requirements  of 
inductive  science,  that  it  is  not  too  much  to  say  that  this 
process  of  generalization  actually  leads  to  the  treatment  of 
cases  which  have  no  real  existence  and  never  had  any, — in 
fact,  to  the  treatment  of  abstractions.  For  who  ever  saw  a 
case  in  which  none  but  the  pathognomonic  symptoms  of 
Pneumonia  were  present — or  of  Rheumatism  or  Dysentery  ? 


2O  HOMOEOPATHY 

Who  ever  saw  ideal  cases  of  these  diseases  ?  We  all  see 
cases  which  present  the  pathognomonic  symptoms  plus 
certain  others  peculiar  to  the  individual,  but  these  vary 
with  the  individual,  and  thus  make  each  case  different  from 
every  other.  We  see  and  treat  the  Pneumonia  or  Rheuma- 
tism of  John  Doe  or  Richard  Roe,  each  of  which  presents, 
in  addition  to  the  pathognomonic  signs  of  the  disease,  certain 
peculiar  modifications  impressed  upon  these  signs  by  the 
temperament  and  idiosyncrasies  of  these  persons,  along 
with  other  symptoms  peculiar  to  each.  For  such  an  indi- 
vidualization  of  disease  as  would  give  equal  (or,  as  they 
deserve,  higher)  rank  to  these  peculiarities  of  the  individual 
patient,  the  method  under  consideration  makes  no  provision. 
This  fallacy  was  perceived  and  well  exposed  by  the  Leipsic 
Professor  who  recently  exclaimed  to  his  class:  "Gentlemen, 
we  have  to  do  with  patients  and  not  with  diseases." 

The  next  objection  to  this  method  is  that  it  does  not  fulfill 
the  first  condition  of  a  physical  science.  It  is  not  capable  of 
infinite  progress.  This  point  needs  no  elaboration.  It  was 
fully  considered  when  the  condition  was  stated.  In  confir- 
mation of  what  was  then  said,  I  need  not  refer  to  the 
successive  rise  and  decline  of  Brunonism,  Broussaisism,  the 
humoral  and  solid  pathology,  the  theory  of  the  dyscrasias 
and  the  reign  and  decade-nee  of  Iron,  Iodine,  Cod  Liver 
Oil,  etc. 

The  second  method  of  Old-School  Therapeutics  is  the 
methodical,  which  discards  theory  and  founds  its  rules  for 
treating  disease  upon  numerical  data,  obtained  from  observa- 
tion or  by  experience  upon  the  sick. 

Given  records  of  three  series  of  cases,  1,000  in  each,  and 
under  three  modes  of  treatment :  Under  treatment  A,  500 
recovered ;  under  B,  300  ;  under  C,  200.  A  is  adopted  as 
the  established  mode  of  treatment  for  the  disease — "  Risum 
teneatis,  Amid?"  An  elaborate  criticism  of  this  method  is. 
unnecessary.  It  is  enough  to  say  that  it  does  not  fulfill 
either  condition  of  a  physical  science.  It  is  incapable  of 


THE   SCIENCE   OF  THERAPEUTICS.  21 

infinite  progress.  The  addition  of  500  cases  to  the  3000 
above  named  might  modify  all  conclusions  and  place  treat- 
ment C  in  advance  of  A  or  B.  There  would  result  a 
complete  revolution  in  practice  and  in  the  direction  of 
investigation. 

But  it  utterly  fails  to  enable  us  to  foresee  and  provide 
against  new  forms  of  disease.  If  a  thousand  or  two  of 
cases  must  be  seen  and  experimented  upon,  in  all  conceivable 
ways,  before  definite  and  trustworthy  conclusions  as  to  the 
best  treatment  can  be  arrived  at,  who  would  not  pray  that 
his  turn  might  come  among  the  third  or  fourth  thousand  ? 
Who  would  not  pity  the  victims  among  the  first  thousands  ? 

Notwithstanding  these  obvious  objections,  this  method  of 
constructing  a  science  of  Therapeutics  upon  observation, 
whether  at  random  or  based  on  experimentation  upon  the 
sick,  has  the  sanction  of  some  of  the  highest  names  in  the 
profession — among  which  it  is  sufficient  to  name  Louis  and 
Forbes.  It  demands,  therefore,  a  more  extended  considera- 
tion. As  it  involves  the  application  of  both  Mathematics 
and  Logic,  the  opinion  of  the  highest  authorities  in  these 
respective  sciences  should  be  conclusive  as  to  the  soundness 
of  the  method,  and  we  content  ourselves  with  quoting  two 
of  them  : 

M.  Auguste  Comte,  one  of  the  first  living  mathematicians, 
and  who  would  therefore  be  disposed  to  apply  mathematical 
methods  to  the  natural  sciences  wherever  this  were  possible, 
expresses  himself  in  the  following  manner  concerning  the 
numerical  method  in  medicine  : 

"  Indeed,  the  spirit  of  calculation  tends  in  our  day  to  intro- 
duce itself  into  this  study  (Physiology),  especially  into  that 
part  of  it  which  relates  to  medical  questions,  by  a  far  less 
direct  method,  under  a  far  more  deceptive  form,  and  with 
infinitely  more  humble  pretensions.  I  wish  to  speak  of  that 
assumed  application  of  it  which  is  called  the  Statistics  of 
Medicine,  from  which  so  many  savants  expect  great  things 
and  which,  from  its  very  nature,  can  lead  only  to  profound 


22  HOMCEOPATHY 

and  direct  degradation  of  the  medical  art  (which  would  be 
reduced  by  it  to  a  method  of  blind  enumeration).  Such  a 
method,  if  we  may  be  allowed  to  call  it  by  the  name  of 
method  at  all,  cannot  in  reality  be  anything  else  than  absolute 
empiricism,  disguised  under  the  frivolous  garb  of  mathe- 
matics. Pushed  to  its  extreme  logical  consequences,  it  will 
tend  to  make  all  rational  medication  radically  disappear  from 
medicine,  by  conducting  the  practitioner  to  make  random 
trials  of  certain  therapeutic  measures  with  the  object  of 
noting  down,  with  minute  precision,  the  numerical  results  of 
their  application.  It  is  evident,  on  principle,  that  the  con- 
tinued variations  to  which  all  organism  is  subject,  are  neces- 
sarily more  pronounced  in  a  pathological  than  in  a  normal 
state,  and  as  a  consequence  of  this  fact,  the  cases  must  be 
even  less  exactly  similar,  whence  results  the  manifest  impos- 
sibility of  making  a  judicious  comparison  between  two  cura- 
tive methods  derived  from  data,  furnished  by  statistical  tables 
alone,  independent  of  some  sound  medical  theory.  No  doubt, 
some  direct  experimentation,  restrained  under  proper  limits, 
might  be  of  great  importance  to  medicine  as  well  as  to 
Physiology,  but  it  is  precisely  under  the  strict  condition  that 
it  shall  never  be  merely  empirical,  but  shall  always  attach 
itself  either  in  institution  or  in  its  interpretation  to  an  entire 
system  of  corresponding  positive  doctrines.  Notwithstanding 
the  imposing  aspect  of  the  forms  of  exactness,  it  would  be 
difficult  to  conceive  of  an  opinion  in  Therapeutics  more  super- 
ficial and  more  uncertain  than  that  which  rests  solely  on  the 
easy  computation  of  fatal  and  favorable  cases,  to  say  nothing 
of  the  pernicious  practical  consequences  of  such  a  manner  of 
proceeding,  when  one  could  not  beforehand  exclude  any  kind 
of  attempt. 

"  It  is  really  deplorable  that  geometricians  have  sometimes 
honored  with  some  kind  of  encouragement,  such  a  profoundly 
irrational  aberration  by  making  vain  and  puerile  efforts  to 
determine  by  their  illusory  theories  of  chances,  the  number  of 
cases  sufficient  to  make  these  statistical  results  legitimate."1 

1  Cours  de  Philosophic  Positive,pa.r  M.  Auguste  Comte,  torn,  iii.,  pp.  418-420. 


THE   SCIENCE   OF  THERAPEUTICS.  23 

And  with  a  direct  reference  to  the  method  of  obtaining  a 
correct  system  of  Therapeutics  by  experimenting  with  indi- 
vidual medicines  and  individual  cases  of  diseases,  and  form- 
ing of  the  results  statistical  tables  from  which  deductions  are 
to  be  drawn  by  the  numerical  method,  the  highest  modern 
authority  in  philosophy,  John  Stuart  Mill,  speaks  in  his  Sys- 
tem of  Logic: l  "Let  the  subject  of  inquiry  be  the  conditions 
of  health  and  disease  in  the  human  body ;  or  (for  greater 
simplicity)  the  conditions  of  recovery  from  a  given  disease  ; 
and  in  order  to  narrow  the  question  still  more,  let  it  be 
limited,  in  the  first  instance,  to  this  one  inquiry:  Is  or  is  not 
a  particular  medicament  (Mercury,  for  instance)  a  remedy  for 
that  disease  ? 

"  The  experimental  method  would  simply  administer  Mer- 
cury in  as  many  cases  as  possible,  noting  the  age,  sex,  tem- 
perament and  other  peculiarities  of  bodily  constitution,  the 
particular  form  and  variety  of  the  disease,  the  particular 
stage  of  its  progress,  etc.,  remarking  in  which  of  these  cases 
it  produced  a  salutary  effect,  and  with  what  circumstances  it 
was  on  those  occasions  combined.  *  *  *  * 

"  When  we  devise  an  experiment  to  ascertain  the  effect  of  a 
given  agent,  there  are  certain  precautions  which  we  never,  if 
we  can  help  it,  omit.  In  the  first  place,  we  introduce  the 
agent  into  the  midst  of  a  set  of  circumstances,  which  we  have 
exactly  ascertained.  It  need  hardly  be  remarked  how  far 
this  condition  is  from  being  realized  in  any  case  connected 
with  the  phenomena  of  life ;  how  far  we  are  from  knowing 
what  are  all  the  circumstances  which  pre-exist  in  any 
instance  in  which  Mercury  is  administered  to  a  living  being. 
This  difficulty,  however,  though  insuperable  in  most  cases, 
may  not  be  so  in  all ;  there  are  sometimes  (though  I  should 
think  never  in  Physiology)  concurrences  of  many  causes 
in  which  we  yet  know  accurately  what  the  causes  are.  But 
when  we  have  got  rid  of  this  obstacle,  we  encounter  another 
still  more  serious.  In  other  cases,  when  we  intend  to  try  an 
experiment,  we  do  not  reckon  it  enough  that  there  be  no  cir- 
1  Harper's  edition,  1848,  p.  260. 


24  HOMOEOPATHY 

cumstances  in  the  case,  the  presence  of  which  is  unknown  to 
us.  We  require  also  that  none  of  the  circumstances  which 
we  do  know  of  shall  have  effects  susceptible  of  being  con- 
founded with  those  of  the  agent  whose  properties  we  wish  to 
study.  We  take  the  utmost  pains  to  exclude  all  causes 
capable  of  composition  with  the  given  cause  ;  or  if  forced  to 
let  in  any  such  causes  we  take  care  to  make  them  such  that 
we  can  compute  and  allow  for  their  influence,  so  that  the 
effect  of  the  given  cause  may,  after  the  subduction  of  those 
other  effects,  be  apparent  as  a  residual  phenomenon. 

"  These  precautions  are  inapplicable  to  such  cases  as  we 
are  now  considering.  The  Mercury  of  our  experiment 
being  tried  with  an  unknown  multitude  (or  let  it  be  a  known 
multitude)  of  other  influencing  circumstances,  the  mere  fact 
of  their  being  influencing  circumstances  implies  that  they 
disguise  the  effect  of  the  Mercury,  and  preclude  us  from 
knowing  whether  it  has  any  effect  or  no.  *  *  * 

"  In  phenomena  so  complicated  it  is  questionable  if  two 
cases  similar  in  all  respects  but  one  ever  occurred ;  and  were 
they  to  occur  we  could  not  possibly  know  that  they  were  so 
exactly  similar. 

"  Anything  like  a  scientific  use  of  the  method  of  experi- 
ment in  these  complicated  cases  is  therefore  out  of  the 
question.  We  can  in  the  most  favorable  cases,  only  discover, 
by  a  succession  of  trials,  that  a  certain  cause  is  very  often 
followed  by  a  certain  effect." 

HAS  "RATIONAL  MEDICINE"  ACCOMPLISHED  NOTH- 
ING?— But  it  may  reasonably  be  asked,  can  it  be  possible 
that  a  large  number  of  men  of  every  generation  since 
Hippocrates,  and  among  them  some  of  the  brightest  intel- 
lects the  world  has  known,  should  have  been  engaged  in  the 
study  and  practice  of  medicine,  with  no  better  result  than 
this — a  simple  vacuity?  I  admit  the  rare  intelligence  and 
devotion  of  the  laborers.  But,  in  the  first  place,  the  task  is 
mightier  than  any  other  essayed  by  man ;  may  it  not 


THE   SCIENCE   OF  THERAPEUTICS.  25 

reasonably  require  ages  to  complete  its  plan  ?  Again,  labor, 
however  intelligent  and  devoted,  if  misdirected,  must  fail  of 
its  end.  If  one  generation  of  intellectual  giants  erect  a 
towering  fabric  and  their  equally  lusty  successors  demolish 
it,  what  does  the  third  inherit  save  a  heap  of  rubbish  which 
it  may  require  the-  best  years  of  its  life  to  clear  away.  Gen- 
eration after  generation  of  wise  men  labored  to  construct 
the  physical  theory  of  the  universe,  yet  not  until  the  recent 
day  of  Newton  did  we  learn  how  to  begin  aright.  True, 
Newton's  predecessors  from  the  earliest  ages  observed  and 
stored  away  a  mass  of  isolated  facts  of  the  greatest  value, 
but  they  knew  not  the  magic  word  wherewith  to  charm 
them  into  order.  In  like  manner,  it  is  not  denied  that  we 
are  indebted  to  our  predecessors  for  a  vast  number  of 
isolated  facts  of  incontestable  value  as  materials  to  be  used 
in  the  construction  of  a  science  of  Therapeutics.  We  are 
indebted  to  them  also  for  the  elaboration  of  those  subsidiary 
sciences — Anatomy,  Physiology,  Pathology,  Chemistry  and 
the  like — in  which,  indeed,  the  great  glories  of  the  medicine 
of  to-day  have  been  won,  and  without  which,  we  cheerfully 
admit,  Therapeutics  as  a  science  could  not  exist. 

But  it  is  said  that  Therapeutics  must  have  advanced  inas- 
much as  the  rates  of  mortality  have  steadily  diminished. 
One  sort  of  improvement  we  gladly  acknowledge.  Simul- 
taneously with  the  spread  of  Homoeopathy,  Old-School 
physicians  began  to  learn  to  abstain  from  mischievous  modes 
of  treatment  formerly  pursued,  and  which  terribly  enhanced 
the  natural  fatality  of  diseases.  Professor  Bennett,  in  the 
introduction  to  his  work  on  Clinical  Medicine,  specifies 
Apoplexy,  Pneumonia  and  Pleurisy,  Syphilis,  Small-pox, 
Phthisis,  Bright's  disease,  and  Favus,  as  diseases  in  treating 
which,  he  says,  "great  improvements  have  been  made;" 
and  he  adduces  this  as  a  proof  of  the  advancement  of 
medicine.  A  reference  to  the  chapters  in  which  he  treats 
of  these  diseases  shows  that  he  conceives  the  "  improvement 
in  their  treatment"  to  consist  in  abstinence  from  methods 


26  HOMOEOPATHY 

which  were  formerly  employed  and  which  he  clearly  proves 
were  very  mischievous.  For  example,  Blood-letting  in 
Apoplexy,  Pneumonia,  Pleurisy,  Phthisis  and  Bright's  dis- 
ease— the  immoderate  use  of  Mercury  in  Syphilis — heroic 
medication  and  external  warmth  in  Small-pox,  and  avoid- 
ance of  all  internal  medication  forFavus,  which  he  conceives 
to  be  a  vegetable  parasite.  This  improvement,  then,  is  purely 
negative,  a  very  poor  ground  on  which  to  claim  positive 
advancement  in  the  construction  of  a  science,  however 
deserving  of  the  gratitude  of  suffering  humanity.  The 
formula  for  improvement  of  all  kinds  is,  "  Cease  to  do  evil ; 
learn  to  do  well."  We  admit  that  the  Old  School  are  learning 
to  obey  the  former,  the  negative  clause.  We  invite  them  to 
advance  and  join  us  in  the  latter,  the  positive. 

Again,  an  extended  knowledge  of  the  remote  causes  of 
disease  and  of  the  principles  of  Hygiene  has  enabled  med- 
ical men  to  prevent  the  occurrence  or  the  spread  of  many 
forms  of  disease.  And  far  be  it  from  us  to  undervalue, 
through  any  love  of  a  newly  constructed  science  of  Thera- 
peutics, this  branch  of  a  physician's  function,  the  forestalling 
or  arrest  of  maladies  by  Hygienic  means.  As  increased 
knowledge  in  this  department  of  science  has  enabled  us  to 
dispense  with  therapeutic  agents  in  many  cases  in  which 
they  were  formerly  resorted  to,  so  we  firmly  believe  that, 
with  the  advancement  of  learning,  Hygiene  will  more  and 
more  curtail  the  boundaries  of  Therapeutics,  until  the  day 
shall  come  when  the  physician  shall  be  prized  as  the  preserver 
rather  than  solely  the  restorer  of  health,  and  shall  be  con- 
sulted respecting  the  means  of  preventing  rather  than  solely 
of  curing  disease,  and  the  "family  doctor"  shall  be  regarded 
as  the  confidential  adviser,  valuable  in  proportion  as  he 
keeps  his  client  out  of  bed,  just  as  the  family  lawyer  is  con- 
fided in,  for  the  purpose  of  keeping  his  clients  out  of  court ! 
In  that  day  there  will  be  fewer  apothecaries. 

DOES    HOMCEOPATHY   FULFILL   THE    CONDITIONS   OF   A 

SCIENCE  OF  THERAPEUTICS  ? — Returning  now  to  our  argu- 


THE   SCIENCE   OF   THERAPEUTICS.  2/ 

ment,  we  find  that  the  field  is  open  for  a  science  of  Thera- 
peutics. In  the  light  of  what  has  been  said  we  proceed  to 
examine  the  claims  of  Homoeopathy  to  the  honor  of  being 
that  science. 

In  its  structure  as  a  science,  Homoeopathy  conforms  to 
the  model  we  have  delineated.  It  consists  of  a  law  or 
formula  which  expresses  the  relation  between  two  series  of 
phenomena,  those  of  a  given  case  of  disease  on  the  one 
hand  and  those  of  a  given  drug-proving  on  the  other.  The 
elaboration  of  each  of  these  series  is  the  province  of  various 
subsidiary  sciences,  and  they  are  analogous  in  their  mode  of 
elaboration.  Each  series,  however,  is  entirely  independent 
of  the  other.  Each  may  be  pursued  independently,  as  a 
branch  of  Natural  Science  and  under  the  heads  of  Pathology 
and  Pathogenesy  respectively,  researches  may  be  made  in 
each  without  any  view  to  a  practical  application  in  the  cure 
of  the  sick.  It  is  only  when  connected  by  the  law  of  their 
relation  (the  formula  of  similarities)  that  they  constitute  the 
science  of  Therapeutics. 

Their  application,  moreover,  in  obedience  to  this  law  is 
based  upon  no  hypothesis  respecting  the  essential  nature  of 
either  variety  of  phenomena  or  of  their  modus  operandi 
where  brought  into  operation.  This  may  surprise  some  who 
know  how  earnestly  Hahnemann  argued  on  these  very 
points  in  his  Organon.  But  these  arguments  were  no  essen- 
tial parts  of  his  system.  They  were  the  results  of  an 
endeavor  to  commend  his  discovery  to  the  prevalent  way 
of  thinking.  They  constitute  the  only  controvertible  part 
of  his  writings,  and  are  the  only  positions  of  his  which  have 
not  triumphantly  withstood  the  assaults  of  his  critics. 

Coming  now  to  apply  to  Homreopathy,  as  tests,  the  condi- 
tions to  which  we  have  shown  that  every  inductive  science 
must  conform,  we  find  in  the  first  place  that  it  is  capable  of 
infinite  progress  in  each  of  its  elements,  without  such  prog- 
ress involving  the  destruction  or  denial  of  what  has  been 
previously  constructed  or  received.  The  study  of  the 


28  HOMOEOPATHY 

phenomena  (whether  of  disease  or  of  drug-action)  was  limited 
at  first  to  the  observation  of  external  manifestations  and 
subjective  sensations  as  these  might  present  themselves  to 
our  senses  unassisted  by  any  of  the  aids  by  which  modern 
science  has  sharpened  them,  or  to  our  minds  unaided  by 
that  knowledge  of  the  connection  and  mutual  relations  and 
dependences  of  symptoms  for  which  we  are  indebted  to 
modern  discoveries  in  Chemistry  and  Pathology.  But  these 
advances  in  Pathology,  great  as  they  have  been,  have  not 
altered  the  relation  which  the  phenomena  of  natural  disease 
bear  to  those  of  drug-disease.  These  phenomena  respect- 
ively, whether  rudely  apprehended,  or  clearly  and  fully 
understood  in  all  their  relations  and  inter-dependences,  still 
bear  the  same  relation  to  each  other — expressed  by  the  law 
Similia  Similibus  Curantur.  And  we  can  imagine  no 
possible  development  of  the  sciences  of  Pathology  and 
Pathogenesy  which  could  alter  this  relation. 

And  then  the  law  itself  may  be  but  a  stepping-stone  to  a 
still  wider  generalization  which  shall  one  day  embrace  both 
it  and  something  besides,  and  which  shall  make  clear  some 
things  which  we  now  see  darkly.  But  should  this  occur,  as 
the  like  has  occurred  in  other  Natural  Sciences,  there  will 
be,  there  can  be,  no  revolutionary  action  in  it.  It  may  be 
that  the  edifice,  as  we  now  occupy  it,  is  still  unfinished, —  it 
may  be  that  other  stories  are  one  day  to  be  added, — but 
assuredly,  as  the  tower  is  to  the  spire,  as  the  buttress  to  the 
pinnacle,  so  will  this  generalization  be  to  that  which  may  be 
constructed  upon  it, —  a  basis, —  an  indispensable  first  step  in 
the  construction  of  the  science. 

The  complete  manner  in  which  the  second  condition— 
that  of  prevision  —  is  fulfilled  by  Homoeopathy  is  a  source  of 
inexpressible  benefit  to  the  race.  It  follows,  from  the  very 
terms  of  the  science,  that  if  the  phenomena  of  a  given  case 
of  disease  be  known,  the  law  of  relation  will  at  once  point 
to  the  appropriate  remedy  (if  this  be  contained  in  the  Ma- 
teria  Medica) ;  and  this  indication  may  be  relied  upon  with 


THE   SCIENCE   OF  THERAPEUTICS.  29 

implicit  confidence,  even  though  no  such  case  of  disease  has 
ever  heretofore  been  subjected  to  treatment.  Conversely, 
when  the  properties  of  a  given  drug  have  been  investigated 
and  its  toxic  phenomena  well  ascertained,  the  physician  is 
able  to  pronounce  with  certainty  what  form  of  disease  it  will 
cure,  even  though  no  such  disease  has  ever  been  witnessed 
or  treated  by  himself,  or  by  anybody.  An  illustrious  exam- 
ple of  this  prevision  was  afforded  by  Hahnemann.  The 
terrible  fatality  of  Asiatic  Cholera,  on  its  first  invasion  of 
Europe,  is  well  known.  In  extenuation  of  their  lack  of 
success,  physicians  of  the  Old  School  pleaded  that  the  disease 
was  new  to  them, — they  had  had  no  opportunities  to  study 
it,  and  to  ascertain  by  experiment  the  effects  of  remedies 
upon  it.  The  plea  was  plausible,  but  fatal  to  the  pretensions 
of  their  science.  In  fact,  it  was  good  for  nothing.  For 
surely  the  first  thousand  cases  should  have  afforded  means 
enough  for  learning  the  Pathology  of  the  disease  and  how 
to  cure  it,  if  this  were  to  be  learned  from  Pathology.  But 
hundreds  of  thousands  perished,  and  yet  the  percentage  of 
mortality  remained  the  same. 

While  the  disease  was  still  on  the  confines  of  Europe, — 
before  it  had  invaded  Germany, —  long  before  either  he  or 
any  of  his  disciples  had  ever  seen  a  case  of  it,  "  Hahnemann, 
guided  by  the  unerring  therapeutic  rule  he  had  discovered, 
at  once  fixed  upon  the  remedies  which  should  prove  spe- 
cific for  it,  and  caused  directions  to  be  printed  and  distributed 
over  the  country  by  thousands ;  so  that  on  its  actual  inva- 
sion the  Homceopathists  and  those  who  had  received  Hahne- 
mann's  directions  were  fully  prepared  for  its  treatment  and 
prophylaxis;  and  thus  there  is  no  doubt  many  lives  were 
saved  and  many  victims  rescued  from  the  pestilence.  On  all 
sides  statements  were  published  testifying  to  the  immense 
comparative  success  that  had  attended  the  employment  of 
the  means  recommended  by  Hahnemann  before  he  had  seen 
or  treated  a  single  case.  This  one  fact  speaks  more  for 
Homoeopathy,  and  the  truth  of  the  law  of  nature  on  which 


3O  HOMCEOPATHY 

the  system  is  founded,  than  almost  any  other  I  could  offer, 
viz. :  that  Hahnemann,  from  merely  reading  a  description  of 
one  of  the  most  appallingly  rapid  and  fatal  diseases,  could 
confidently  and  dogmatically  say,  such  and  such  a  medicine 
will  do  good  in  this  stage  of  the  disease,  such  and  such  other 
medicines  in  that ;  and  that  the  united  testimony  of  hundreds 
of  practitioners  in  all  parts  of  Europe  should  bear  practical 
testimony  to  the  accuracy  of  Hahnemann's  conclusions."1 

We  may  add  that  in  the  second  Epidemic  of  Cholera  in 
1849,  the  Old  School,  despite  their  experience  in  1831-34, 
had  but  little  better  success,  while  again  the  justice  of  Hah- 
nemann's conclusions  and  the  claim  of  Homoeopathy  to  that 
prevision  which  characterizes  a  true  science  were  vindicated 
by  the  splendid  success  of  the  Homoeopathic  treatment. 

John  Stuart  Mill,  in  the  portion  of  his  work  on  Logic 
from  which  we  have  already  quoted,  in  speaking  of  the  three 
methods  of  investigation, —  that  of  observation,  that  of  exper- 
imentation, and  that  of  deduction, —  after  showing  conclu- 
sively that  the  former  two  are  inapplicable  to  medicine, 
speaks  of  the  deductive  method  in  terms  which  are  (unin- 
tentionally of  course,  and  for  this  very  reason  they  are  the 
more  conclusive)  a  description  of  the  philosophy  of  Homoeop- 
athy. "  If,  for  instance,  we  try  the  experiments  with  Mer- 
cury on  a  person  in  health,  in  order  to  ascertain  the  general 
laws  of  its  action  upon  the  human  body,  and  then  reason 
from  these  laws  to  determine  how  it  will  act  upon  persons 
affected  with  a  particular  disease,  this  may  be  a  really  effect- 
ual method,  but  this  is  deduction.'" 

How  TO  STUDY  THE  SCIENCE  OF  THERAPEUTICS.— 
The    method   of    studying  the    two  series    of    phenomena 
which,    together  with    the    law  of  relation,    constitute  the 
science  of  Therapeutics,  follows  from  what  has  been  said. 

When  first  brought  into  the  presence  of  a  concrete  case  of 
disease,  the  business  of  the  physician  is  to  ascertain  what 

1  Dudgeon's  Lectures  on  Homoeopathy,  p.  37. 


THE    SCIENCE   OF   THERAPEUTICS.  31 

branch  of  medical  science  he  is  called  upon  to  exercise.  Is 
the  case  one  which  requires  hygienic  management  or  thera- 
peutic, or  both,  or  is  the  patient  beyond  the  reach  of  art  ? 
To  answer  these  questions  a  diagnosis  and  prognosis  must 
be  made,  and  to  make  these,  a  knowledge  of  the  remote  and 
proximate  causes  and  of  the  course  and  determination  of 
diseases  is  required.  In  a  word,  a  knowledge  of  Physiology 
and  Pathology  is  indispensable  on  the  very  threshold  of  med- 
ical practice  and  before  any  question  of  Therapeutics  has 
arisen. 

When  these  preliminary  questions  have  been  settled  and 
the  case  has  been  found  to  come  within  the  domain  of  Ther- 
apeutics, its  phenomena  are  to  be  studied  in  such  a  way  that 
all  deviations  from  a  normal  state  may  be  perceived,  as  well 
those  which  are  common  to  a  number  of  similar  cases,  as 
more  particularly  those  which  seem  to  be  peculiar  to  the 
individual  case  in  hand,  and  which  therefore  serve  to  give  it 
individuality  and  to  distinguish  it  from  all  other  and  similar 
cases.  The  case  is  to  be  then  individualized  as  sharply  as 
possible,  and  a  complete  picture  of  the  morbid  phenomena 
obtained  in  their  natural  groups  and  connections. 

Now,  morbid  phenomena  are  deviations  from  healthy 
phenomena.  How  can  we  recognize  the  deviations  unless 
we  are  familiar  with  the  standard?  How  can  we  appreciate 
morbid  phenomena  save  through  a  knowledge  of  Physiology, 
which  is  the  science  of  healthy  phenomena  ? 

In  like  manner  we  are  able  to  get  a  complete  picture  of 
the  morbid  symptoms  only  by  an  orderly  and  methodical 
investigation ;  and  such  an  investigation  is  possible  to  those 
alone  who  are  familiar  with  the  relations  and  sequences  of 
morbid  phenomena, —  that  is  to  say,  with  Pathology.  A 
simple  reference  to  practical  experience  will  prove  this.  A 
patient  complains  of  pain  in  her  left  hypochondrium,  distress 
and  faintness  in  the  epigastrium,  vertigo  and  various  symp- 
toms of  dyspepsia,  but  never  thinks  of  mentioning — perhaps 
is  unconscious  of — certain  evidences  of  uterine  disease  to 


32  HOMCEOPATHY 

which  the  attention  of  the  physician  is  instantly  directed 
through  his  knowledge  of  the  connection  and  sequence 
of  symptoms.  So  of  the  connection  of  certain  forms  of 
vomiting  with  disease  of  the  brain  or  of  the  kidneys,  etc.,  etc. 

Clearly,  then,  Physiology  and  Pathology  are  quite  indis- 
pensable to  the  physician,  and  they  speak  with  little  thought 
who  affirm  that  these  sciences  are  of  no  value  to  the  Homoe- 
opathist  and  are  disregarded  by  him.  They  are  the  sciences 
respectively  of  healthy  and  morbid  phenomena.  He  cannot 
take  the  first  step  in  the  study  of  disease  or  of  Materia 
Medica  save  by  their  aid.  But  he  restricts  them  to  their 
legitimate  function.  Pathology  is  for  him  not  a  guide  in 
Therapeutics,  but  an  instrument  which  he  uses  in  studying 
those  phenomena  which  are  to  be  respectively  the  subject  and 
the  agents  of  his  therapeutic  operations. 

Having,  by  the  aid  of  Pathology,  arrived  at  a  complete 
and  comprehensive  knowledge  of  the  morbid  phenomena,  he 
passes  on  beyond  the  confines  of  that  science  to  a  higher  and 
more  complex  science,  whose  domain  is  the  relation  of  the 
phenomena  of  which  he  has  thus  acquired  a  knowledge,  with 
other  phenomena.  Through  Pathology  he  learns  to  know 
disease,  but  it  is  through  Therapeutics  alone  that  he  can  cure 
it.  And  it  is  quite  time  that  it  were  well  understood  not 
only  by  the  profession  but  also  by  the  public,  that  to  know 
the  nature  and  course  of  a  disease  is  not  of  necessity  to  know 
how  to  cure  it.  It  may  be  a  necessary  preliminary  step  — 
but  it  is  nothing  more.  Nor  is  this  true  of  medicine  alone. 
My  carriage  breaks  down  ;  I  well  know  where  it  has  broken 
and  why  and  how  ;  yet  this  knowledge  does  not  involve  the 
knowledge  how  to  forge  and  weld  the  iron  that  has  broken 
and  so  to  mend  it.  For  that  I  require  knowledge  of  another 
sort.  The  nature  of  Pneumonia,  of  Cholera,  or  Rheumatism 
is  as  well  known  as  those  of  any  disease  can  be;  "their 
Pathology,"  as  doctors  say,  "is  well  understood,"  yet  this 
gives  no  clue  to  their  therapeutic  treatment, —  it  is  no  guide 
to  the  special  stimulus  which  must  be  brought  to  bear  on  the 


THE   SCIENCE   OF   THERAPEUTICS.  33 

diseased  organs  to  lead  them  back  to  healthy  action.  This 
stimulus  must  be  discovered  by  quite  another  method  ;  its 
discovery  is  the  object  of  a  distinct  process. 

Thus  Pathology,  restricted  to  its  proper  sphere,  is  an  indis- 
pensable auxiliary  to  the  study  of  the  subject  of  Therapeutics. 
It  may  be  further  subservient  in  enabling  the  physician  to 
group  the  symptoms  of  a  case  in  such  a  way  as  more  readily 
to  marshal  and  retain  them  in  memory.  Nor  is  generaliza- 
tion of  this  kind  at  all  repugnant  to  the  letter  or  spirit  of 
Hahnemann's  method  or  of  homoeopathic  science. 

The  generalization  to  which  Hahnemann  objected  was  to 
that  of  disease  in  general  upon  nosological  hypotheses  made 
on  theoretical  grounds,  and  then  applied  a  priori  \.o  individual 
cases.  That  to  which  we  refer  is  a  generalization  made  spe- 
cially in  each  case,  consisting  of  a  grouping  of  connected 
symptoms  under  one  general  term  and  extending  only  to 
such  pathological  states  as  are  well  defined  and  constant,  such, 
for  example,  as  Anaemia,  Plethora,  the  proportion  between 
the  affections  of  different  parts  of  the  nervous  system,  etc., 
under  which  we  may  group  a  number  of  generic  symp- 
toms to  the  great  relief  of  our  memory,  while  at  the  same 
time  the  individual  or  characteristic  symptoms  are  not  only 
not  obscured  by  the  process  but  are  even  brought  more 
sharply  into  view,  as  will  be  evident  when  we  consider  this 
matter  more  at  length  under  the  head  of  the  Study  of  the 
Materia  Medica. 

THE  STUDY  OF  THE  MATERIA  MEDICA. — The  method 
by  which  any  subject  may  be  most  successfully  studied  must 
depend  on  the  use  which  is  to  be  made  of  the  knowledge 
thus  gained.  It  is  proper,  then,  to  inquire  at  the  outset  in 
what  way  the  knowledge  of  Materia  Medica  is  to  be  made 
subservient  to  the  treatment  of  disease. 

In  accordance  with  the  homoeopathic  law,  we  select  for  the 
cure  of  each  individual  case  of  disease  that  remedy  of  which 
the  pathogenetic  effects  are  most  similar  to  the  symptoms  of 
4 


34  HOMCEOPATHY 

the  case.  In  the  process  of  making  this  selection  we  must 
pass  in  mental  review  the  various  drugs  which  compose  the 
Materia  Medica,  take  a  comprehensive  view  of  the  pure 
effects  of  each,  and  institute  a  comparison  between  each  in 
turn,  and  the  case  for  which  we  are  prescribing.  This  is  the 
theory  of  the  process. 

Now,  it  is  evident  that,  in  order  to  select  from  a  number  of 
candidates  one  which  most  nearly  resembles  a  given  standard, 
we  must  be  familiar,  not  merely  with  the  general  properties 
of  all  the  candidates  or  of  certain  classes  into  which  they  may 
be  divided,  but  also  with  certain  properties  more  or  less  pecu- 
liar to  each  one  of  the  candidates,  and  which  shall  serve  to 
distinguish  each  of  them  from  all  the  others.  In  fact  our 
method  requires  the  strictest  individualization  of  both  disease 
and  remedy.  We  are  so  to  study  Materia  Medica  as,  above 
all,  to  bring  into  strong  relief  and  fix  firmly  in  memory  those 
peculiarities  of  each  drug  which  are  not  met  with  in  any 
other,  and  which  therefore  serve  to  individualize  and  give 
character  to  the  drug  that  produces  them  and  which  are 
called  its  "  characteristic  symptoms."  This  term  having  been 
much  and  loosely  used  of  late,  it  may  not  be  unprofitable  to 
devote  a  few  words  to  the  subject  of  characteristic  symp- 
toms. 

By  some  writers  the  leading  and  most  obvious  and  most 
frequently  recurring  symptoms  are  called  characteristic. 
Thus  Bennett  calls  fever  a  characteristic  of  the  Exanthemata. 
By  others  the  pathognomonic  symptoms  of  a  class  of  diseases 
are  called  characteristic, — by  others  the  pathologico-anatom- 
ical. 

Now,  the  signification  of  such  a  word  as  characteristic  is 
not  absolute.  It  depends  on  the  connection  in  which  you 
please  to  use  it,  and  which  is  determined  by  the  question, 
"  Characteristic  of  what?"  In  the  instances  just  adduced, 
the  varieties  of  symptoms  cited  may  indeed  be  called  char- 
acteristic, but — characteristic  of  what?  Of  classes  (the 
Exanthemata),  of  groups  (nosological) — but  not  of  indi- 


THE    SCIENCE   OF   THERAPEUTICS.  35  \ 

vidttals.  But  the  only  sense  in  which  Homoeopathists  can 
use  the  term  is  in  its  application  to  individuals.  Hence  a 
characteristic  symptom  must  mean  one  which  is  possessed 
by  none  other  than  the  individual  drug  of  which  it  is  predi- 
cated, and  to  which  therefore  it  gives  character  as  an  indi- 
vidual. In  this  sense  it  corresponds  precisely  to  those 
features  of  a  man  by  which  his  friends  are  enabled  to  distin- 
guish him  from  other  persons  and  to  recognize  him  at  a  glance. 

It  is  obvious  that  these  characteristic  symptoms  so  pre- 
cious to  the  Therapeutist  may  seem  to  be  of  little  or  no 
pathological  value, — may  even  seem  accidental  to  those  who 
forget  that  there  are  no  accidents  in  Nature.  They  would 
be  valueless  if  we  did  not  need  to  individualize,  but  could  be 
content  with  grouping  our  diseases  and  remedies. 

To  the  Naturalist  whose  object  it  is  to  group  his  speci- 
mens, it  is  sufficient  to  know  that  John  Doe  has  a  vertebral 
column,  is  a  mammal,  has  two  hands,  and  is  a  Caucasian — 
because  this  enables  him  at  once  to  place  John  Doe  in  the 
variety  Caucasian  of  the  species  man,  and  his  analysis  goes 
no  farther.  From  this  his  whole  physiological  status  follows. 
But  these  items  of  general  knowledge  would  hardly  enable 
the  sheriff  to  recognize  John  Doe  in  Broadway.  It  is  of  no 
importance  to  the  Naturalist  that  he  has  such  "  accidental  " 
peculiarities  as  an  aquiline  nose,  black  eyes  and  hair,  and  a 
brown  mole  on  the  left  ala  nasi ;  but  these  very  peculiarities 
are  all  important  to  the  sheriff,  for  they  give  him  the  means 
of  detecting  the  object  of  his  search  upon  the  crowded  street. 
It  must  not  be  forgotten,  however,  that  the  points  on  which 
the  Naturalist  laid  stress  are  equally  important  to  the  sheriff; 
for  if  the  latter  should  bear  in  mind  only  the  individual 
peculiarities  of  the  object  of  his  quest  and  should  forget  that 
he  is  a  Caucasian,  he  might  find  the  former  in  the  person  of 
an  Indian,  or,  if  he  should  forget  that  he  is  a  bimanous 
creature,  he  might  arrest  a  monkey. 

To  drop  the  figure,  then,  it  is  evident  that  we  must  seek 
to  discover  among  the  symptoms  of  every  drug  certain  ones 


36  HOMOEOPATHY 

that  are  produced  by  no  other  drug,  and  which  shall  serve 
to  distinguish  it  from  all  other  drugs  similar  in  other  re- 
spects ;  that  these  symptoms  will  often  be  unimportant  and 
trivial  in  a  physiological  point  of  view ;  furthermore,  that  we 
must,  for  convenience  sake,  when  the  number  of  drugs  in 
our  Materia  Medica  has  become  considerable,  endeavor  so 
to  group  them,  on  the  basis  of  certain  clearly  defined  symp- 
toms or  collections  of  symptoms,  that  for  the  purpose  of 
preliminary  examination  and  comparison,  these  groups  may 
be  regarded  and  compared  as  though  they  were  individual 
drugs. 

Let  us  suppose  a  case  of  uterine  haemorrhage.  As  many 
as  forty  drugs  probably  produce  uterine  haemorrhage.  On 
the  basis  of  this  symptom,  they  form  a  group  isolated  from 
the  three  hundred  and  forty  remaining  drugs  of  the  Materia 
Medica.  We  select  this  group  from  the  Materia  Medica,  and 
now  we  must  select  a  remedy  from  the  group.  It  were  a 
tedious  task  to  consider  and  compare  them  one  by  one.  But 
we  group  them  again ;  ten  of  them  produce  dark-colored 
and  ten  florid  haemorrhage ;  ten  a  limpid  and  ten  a  clotted 
discharge.  Our  case  has  a  dark-colored  discharge.  Our 
choice  is  now  restricted  to  ten  drugs.  But  of  the  ten  which 
produce  a  dark  discharge,  only  five  produce  simultaneously 
a  congestive  headache.  Thus  we  are  limited  to  five  drugs. 
Thus  far,  the  distinctions  on  which  our  grouping  has  been 
based  (or  which  have  been  characteristic  of  the  groups) 
have  had  a  pathological  significance  and  importance.  We 
can  find  no  such  basis  for  any  further  subdivision  into 
groups.  But  we  observe  in  the  case  a  peculiar  subjective 
symptom.  The  patient  complains  "  as  though  a  living  body 
were  moving  through  the  abdomen."  This  may  seem  trivial. 
It  is  equally,  however,  a  symptom  produced  by  Crocus,  which 
is  one  of  the  five  remedies  to  which  our  choice  had  been 
restricted,  and  it  is  produced  by  no  other  drug  in  the  Materia 
Medica.  It  is,  then,  a  characteristic  symptom  of  Crocus, 
enabling  us  to  individualize  Crocus,  and  to  distinguish  it 


THE   SCIENCE   OF  THERAPEUTICS.  37 

from  all  the  other  drugs  which  in  many  other  respects  agree 
with  it. 

It  will  be  observed  that  dark-colored  uterine  haemorrhage, 
though  produced  by  Crocus,  cannot  be  said  to  be  character- 
istic of  it.  It  is  a  characteristic  symptom  of  a  group  to 
which  Crocus  belongs,  but  not  of  Crocus,  for  it  is  produced 
by  the  other  members  of  this  group  as  well  as  by  Crocus. 

Characteristic  symptoms  must  of  necessity  be  for  the  most 
part  subjective  and  seemingly  trivial  phenomena.  A  list  of 
them  alone,  if  presented  as  the  pathogenesis  of  a  drug, 
would  be  as  meaningless,  and  at  first  sight  as  ridiculous,  as  a 
list  of  the  colors  and  marks  and  angles  and  curves  by  which 
friends  recognize  each  other  would  be,  if  presented  alone  as 
the  sum  total  of  the  properties  of  certain  genera  and  species 
of  the  animate  creation.  As  a  background  to  the  latter, 
there  must  be  a  series  of  phenomena  capable  of  morpholog- 
ical and  organic  arrangement,  and  as  the  basis  of  the  former 
we  must  have  a  series  of  objective  and  organic  symptoms 
capable  of  physiological  and  pathological  arrangement  and 
of  approximate  explanation.  But  it  must  never  be  forgotten 
that  without  the  characteristics,  as  we  have  described  them^ 
there  can  be  no  individualization,  and  without  this  there  can 
be  no  accurate  homoeopathic  prescription, 

The  truth  of  this  is  made  apparent  by  a  glance  at  the 
history  of  Homoeopathy.  Certain  of  Hahnemann's  followers 
discarded  the  apparently  trivial  subjective  phenomena  from 
the  provings  of  drugs,  retaining  only  the  objective,  organic 
symptoms.  They  thus  lost  the  means  of  distinguishing 
between  the  individual  members  of  the  groups  of  remedies. 
It  was  thenceforward  useless  for  them  to  discriminate  closely 
between  individual  cases  of  any  one  type  of  disease.  Hence, 
inevitably,  arose  the. fashion  of  prescribing  a  specific  remedy 
for  a  disease, —  as  the  phrase  went, — putting  the  leading 
members  of  respective  groups  of  drugs  and  diseases  to  rep- 
resent the  whole  groups.  These  were  the  so-called  "  specif- 
ikers," — who  had  one  or  two  remedies  for  dysentery,  one 


38  HOMCEOPATHY 

for  hooping-cough,  one  or  two  for  scarlatina,  etc.,  "  of  whom 
the  world  is  weary." 

But  the  characteristic  is  not  always  a  definite  symptom. 
Sometimes  it  is  so, —  as  in  the  case  of  Crocus,  and  as  in  the 
peculiar  diplopia  of  Stramonium.  But  sometimes  it  resides 
in  a  peculiar  condition  which  attaches  to  some  symptom 
common  to  two  or  more  drugs.  This  condition  may  be  of 
time,  or  circumstance,  or  concomitance.  Thus,  if  two  drugs 
have  the  symptom  "  dry  cough  from  tickling  in  the  supra- 
sternal  fossa," — but  to  one  is  added  the  condition  "occurring 
only  in  the  evening," — this  condition  of  time  is  the  charac- 
teristic of  that  drug  in  so  far  as  the  dry  cough  is  concerned;  or 
if  one  have  this  condition  of  circumstance,  that  "  the  cough 
is  aggravated  by  inspiring  cold  air," — this  condition  is  the 
characteristic ;  or  if  one  have  the  concomitant  that  the  cough 
is  attended  by  retching, —  this  condition  of  concomitance  is 
the  characteristic. 

Sometimes  the  characteristic  resides  in  the  conditions 
collectively.  We  borrow  examples  from  Dr.  Drysdale's 
admirable  Introduction  to  The  British  Repertory  : 

"  Pain  in  the  stomach  with  nausea  occurs  under  twenty- 
eight  medicines. 

"  Pain  in  the  stomach  in  the  morning  under  thirty- 
seven. 

"  Pain  in  the  stomach  with  nausea  in  the  morning  under 
four  only." 

Or  it  may  reside  in  a  concomitant. 

"  Dry  retching  occurs  under  forty- five  drugs. 

"  Dry  retching  in  the  morning  under  five. 

"  Dry  retching  with  eructation  under  one  only  —  Ledunv" 

Every  drug-proving,  then,  is  to  be  studied  in  a  two-fold 
way  :  On  the  one  hand,  so  as  to  enable  us  to  attach  it  in 
our  memory  to  certain  groups  of  drugs  to  which  it  shows 
marked  general  resemblances ;  and,  on  the  other  hand,  so  as 
to  bring  out  clearly  into  view  those  characteristics  which 
distinguish  it  from  all  the  other  drugs  of  these  groups  in 


THE    SCIENCE   OF   THERAPEUTICS.  39 

particular  and  of  the  Materia  Medica  in  general.    Our  study 
will  be  at  once  synthetic  and  analytic. 

Such  a  study  is  of  necessity  comparative  in  its  nature. 
Each  positive  step  in  the  study  of  a  drug  involves  a  question 
of  the  correspondence  or  difference  of  other  drugs  in  respect 
of  that  step.  An  isolated  study  of  all  the  remedies  would 
not  give  us  an  available  knowledge  of  the  Materia  Medica. 
It  is  not  enough  to  know  that  Pulsatilla,  Nux  vomica  and 
Chamomilla  each  produce  diarrhoea  of  a  certain  kind.  We 
must  also  know  and  fix  in  our  minds  the  similarities  and  dif- 
ferences of  each  of  these  diarrhoeas  to  those  of  the  two 
other  and  of  all  other  drugs.  The  study  of  one  drug  is,  in 
fact,  then,  the  study  of  the  whole  Materia  Medica.  One  is 
never  so  competent  to  thoroughly  master  a  proving  as  when 
he  has  already  mastered  all  other  provings.  The  first  effort 
must  necessarily  be  the  least  satisfactory,  the  most  im- 
perfect. 

This  is  the  task  to  which  the  student  of  Materia  Medica  is 
invited  and  at  which  his  predecessors  have  been  laboring  for 
fifty  years.  Why,  he  may  ask,  has  not  this  been  wrought 
out  and  systematized  by  those  who  have  gone  before?  Why 
is  the  Materia  Medica  left  in  the  same  state  in  which  Hahne- 
mann  placed  it  fifty  years  ago? 

Our  Materia  Medica  consists  of  the  provings  of  drugs 
upon  the  healthy,  made  by  Hahnemann  and  his  disciples. 
These  provings,  as  we  have  them,  are,  for  the  most  part,  a 
formal  arrangement  of  the  symptoms  subjective  and  object- 
ive observed  by  the  prover  or  his  friends.  No  attempt  is 
made,  with  but  few  exceptions,  to  trace  any  pathological 
connection  between  symptoms,  or  to  give  any  physiological 
explanations,  or  to  distinguish  between  characteristic  and 
generic  symptoms.  The  symptoms  alone  are  given,  just  as 
the  symptoms  of  a  case  of  disease  would  be  given  by  an 
intelligent  but  uninstructed  patient  who  unfolds  his  case  to 
us  in  as  plain  untechnical  words  as  he  can,  leaving  to  us  the 
task  of  tracing  connections  and  contriving  explanations. 


40  HOMOEOPATHY 

There  they  stand,  records  of  facts  made  in  the  plain  vernac- 
ular, intelligible  so  long  as  the  language  shall  endure. 

But  Hahnemann  had  a  much  higher  idea  of  the  kind  of 
knowledge  of  Materia  Medica  which  a  physician  requires 
than  this  statement  would  imply.  In  an  essay  on  "  The 
Power  of  Small  Doses,"  in  Hufeland's  Journal,  he  describes 
this  knowledge  as  follows :  "  What  organs  it  (the  drug) 
deranges  functionally,  what  it  modifies  in  other  ways,  what 
nerves  it  principally  benumbs  or  excites,  what  alterations  it 
effects  in  the  circulation  and  digestive  operations,  how  it 
affects  the  mind,  how  the  disposition,  what  influence  it  exerts 
over  some  secretions,  what  modification  the  muscula/  fiber 
receives  from  it,  how  long  its  action  lasts,  and  by  what 
means  it  is  rendered  powerless,  etc.,  etc."  Why,  then,  did 
he  not  construct  his  Materia  Medica  on  this  model  ?  Un- 
questionably because,  with  a  wonderful  sagacity  which 
together  with  his  brilliant  genius  and  his  prodigious  learning 
made  him  the  "  double-headed  prodigy,"  which  Jean  Paul 
Richter  called  him,  Hahnemann  clearly  perceived  the  follow- 
ing truths:  that  the positi 've  facts  with  which  a  physician  has 
to  deal  in  constructing  a  Materia  Medica  are  the  observations 
of  the  prover  recorded  in  plain,  unfigurative,  non-hypotheti- 
cal language.  That  the  construction  which  he  saw  to 
be  so  desirable  must  be  the  result  of  the  application  of  the 
sciences  of  Physiology  and  Pathology  to  these  facts.  That 
the  facts  of  the  proving  being  of  the  nature  of  positive 
observation  are  enduring  and  unchangeable.  But  that  the 
sciences  of  Physiology  and  Pathology,  being  incomplete  and 
progressive,  are  continually  undergoing  change,  and  that  their 
terms  must  therefore  be  ever  varying  in  significance  as  the 
theories  on  which  the  sciences  are  based  vary.  That,  con- 
sequently, a  Materia  Medica  constructed  by  him  out  of  these 
two  elements,  one  constant  and  the  other  variable,  would  of 
necessity  be  transient, — could  not  be  enduring, —  would 
soon  grow  obsolete  and  in  its  decline  would  carry  out  of 
sight  the  constant  element  also,  and  thus  the  labor  of  the 


THE   SCIENCE    OF   THERAPEUTICS.  4! 

provers  would  soon  be  lost  to  the  world.  Such  a  structure 
would  have  involved  an  intermingling  of  the  current  physio- 
logical theories  with  the  facts  derived  from  observation. 
The  precise  point  and  extent  of  the  intermingling  would 
soon  become  undistinguishable  and  thus  a  vitiated  record 
would  be  transmitted  to  posterity  such  as  the  advance  of 
science  would  soon  render  useless.  A  comparison  of  the 
present  state  of  Physiology  with  that  of  1800,  of  which  the 
very  terms  are  almost  obsolete,  makes  the  great  wisdom  of 
this  view  apparent.  On  the  other  hand,  the  pure  records  of 
observed  facts,  untainted  by  theoretical  speculations,  come 
to  us  from  the  Master's  hand  as  pure,  as  intelligible,  as 
available  as  when  first  recorded. 

We  have  the  same  material  for  the  construction  of  a  phys- 
iological theory  of  the  drug-action  that  Hahnemann  had, 
and  we  can  construct  it  with  the  advantage  in  our  favor  of  the 
great  advances  which  Physiology  and  Pathology  have  made 
since  Hahnemann's  day.  This  is  the  work  which  each  of  us 
must  do  for  himself.  No  other  can  do  it  for  him.  The  result 
of  his  labor  may  and  will  differ  somewhat  from  that  of  every 
other  student,  for  with  the  light  of  the  auxiliary  sciences  he 
forms  a  judgment  concerning  observed  facts,  and  the  sig- 
nificance of  a  fact  is  measured  by  the  capacity  of  the  observer}- 

The  student  should  seek  his  knowledge  of  Materia  Medica 
at  the  fountain  head,  in  the  original  publications  of  Hahne- 
mann's Materia  Medica  Pura  and  Chronic  Diseases  in  the 
provings  in  Stapf's  Archiv.  and  in  the  Austrian  and  other 
journals. 

The  Manuals,  however  convenient  for  reference  in  the 
hurry  of  practice,  are  not  suitable  for  systematic  study.  In 
some  of  them,  the  phraseology  of  the  prover  has  been  altered. 

1  Lest  by  an  omission  I  expose  my-  it  is  incumbent  on  each  generation  to 

self  to    misconstruction,  I   may    say  re- prove  to  a  certain  extent  the  rem- 

that  inasmuch  as  advances  in  collat-  edies  of  the  Materia  Medica  so  as  to 

eral  medical    sciences    are   affording  bring  these  aids  to  bear  on  the  study 

continually  new   aids  to  observation,  of  Pathogenesy. 


42  HOMOEOPATHY 

In  others,  the  symptoms,  as  reported  by  the  prover,  have 
been  arbitrarily  sundered  into  fragments  and  these  fragments 
are  scattered  throughout  the  record.  Or  symptoms  ex  usu 
in  morbis  have  been  introduced  and  the  names  of  diseases  sup- 
posed to  have  been  cured  by  the  drug  are  incorporated  with 
the  pure  symptoms.  In  all  of  them  the  arrangement  is  some- 
what altered.  In  many,  attempts  at  abbreviation  have  been 
made,  and  with  no  better  success  than  if  one  should  squeeze 
one's  lemons  to  lessen  the  bulk  of  one's  luggage  and  yet 
hope  to  have  good  lemonade  at  the  end  of  one's  journey ; 
for  it  always  happens,  and  must  from  the  nature  of  the  case, 
that  the  skins  are  the  part  retained  while  the  juice  is  thrown 
away. 

If  a  Manual  must  be  employed,  that  of  Noack  and  Trinks 
seems  preferable ;  for  it  preserves  the  phraseology  of  the 
prover  and  does  not  to  any  great  extent  sunder  groups  of 
symptoms,  while  it  places  under  distinct  headings  the  pure 
symptoms,  and  the  clinical  effects  of  the  drugs  and  the 
theoretical  speculations  of  the  compilers,  so  that  the  student 
is  in  no  danger  of  mistaking  the  one  for  the  other,  a  danger 
to  which  Jahr's  Manual  does  certainly  expose  him,  and  for 
which  reason  Jahr's  work  is  less  desirable  than  that  of  Noack 
and  Trinks. 

We  have  dwelt  at  some  length  on  the  sources  from  which 
the  student  should  seek  his  knowledge  of  Materia  Medica — 
and  with  good  reason !  "  For,  can  a  bitter  fountain  send 
forth  sweet  waters  ?  "  "  Do  grapes  grow  on  thorns,  or  figs 
on  thistles  ? "  If  the  student  should  fall  among  false  or 
incompetent  teachers,  could  the  doctrine  and  practice  he 
learns  be  true  and  successful  ?  Now,  it  will  be  observed  that 
the  records  and  provings  and  the  manuals  of  Materia  Medica 
to  which  we  have  commended  the  student  are  all  German 
works,  while  nine-tenths  of  our  American  and  English  prac- 
titioners and  students  are  unacquainted  with  the  German 
language.1  It  is  humiliating  to  us  to  be  compelled  to  say 

1  The  Author  considered  a  knowl-      to  a  student  of  Homoeopathy. —  ED. 
edge  of  German  almost  indispensable 


THE    SCIENCE    OF   THERAPEUTICS.  43 

that  there  are  no  trustworthy  manuals  in  the  English  lan- 
guage and  no  translations  of  the  German  works  which  we 
have  named  on  which  reliance  can  be  placed.  We  have 
translations  of  Hahnemann's  Materia  Medica  and  Chronic 
Diseases  and  of  Stapf  s  Contributions  to  the  Materia  Medica, 
by  Dr.  Hempel.  But,  either  (perhaps  we  should  say  both] 
from  lack  of  moral  capacity,  or  of  intellectual  and  profes- 
sional acquirements,  or  from  haste  and  carelessness,  the 
translator  has  so  marred  these  works  by  errors  of  omission 
and  of  translation,  that  they  are  to  the  student  and  prac- 
titioner what  false  lights  on  a  difficult  coast  are  to  the  unsus- 
pecting mariner. 

Dr.  Hempel  translated  also  Jahr's  New  Manual  or  Symp- 
tomen  Codex,  and  claims  to  have  incorporated  with  it  nearly 
all  that  is  valuable  in  the  Manual  of  Noack  and  Trinks,  thus 
making  it  the  most  complete  and  perfect  work  of  the  kind  in 
existence,  and  the  best  possible  in  the  present  state  of  our 
science.  This  translation  was  published  with  a  preface  by 
Dr.  C.  Hering  and  under  the  high  sanction  of  his  name  and 
that  of  Dr.  Gray,  of  New- York.  It  is  almost  universally 
used  in  this  country  and  in  England,  and  the  knowledge  of 
the  Materia  Medica  and  of  the  true  practice  of  Homoeop- 
athy possessed  by  the  rising  generation  of  practitioners  is, 
in  the  main,  what  this  manual  is  capable  of  affording. 

If  now,  I  should  say  that  this  translation  and  compilation 
contains  all  the  errors,  omissions  and  perversions  which  ren- 
dered Dr.  Hempel's  former  translations  untrustworthy,  along 
with  many  others  peculiar  to  this  work,  I  should  surely  hear 
in  reply  that  Dr.  Hering  has  expressly  in  his  preface  com- 
mended the  diligence  and  accuracy  and  zeal  of  the  trans- 
lator, and  I  should  be  referred  to  page  six  of  the  preface,1 
where  Dr.  Hering  is  made  to  say,  "  The  Editor  has,  with 
extraordinary  minuteness  and  labor,  compared  the  two  man- 
uals and  has  transferred  to  the  manual  of  Jahr  all  additional 
drugs  and  pathogenetic  effects  contained  in  Noack  and 
Trinks'  work."  What  could  I  say  in  offset  to  this  indorse  - 

1  Jahr's  New  Manual  or  Symptomen  Codex,  pref.  vi. 


44  HOMCEOPATHY 

ment  of  Dr.  Hering  ?  There  is  a  word  to  say  on  the  subject 
of  this  preface.  It  was  unquestionably  written  originally  by 
Dr.  Hering  in  German.  The  English  translation,  by  whom- 
soever made,  seems  not  to.  have  been  altogether  satisfactory 
to  Dr.  Hering  (as  well  it  might  not  be),  for  the  German 
original  was  published  by  him  (a  "  verbatim  copy,"  as  he 
says)  in  the  Allg.  Horn.  Zeitung.  The  English  preface  to 
Jahr's  New  Manual  differs  from  this  German  original  far 
more  widely  than  the  license  of  scholarship  will  at  all  justify. 
In  a  foot-note  to  the  original  of  the  passage  we  have  quoted 
above  in  commendation  of  the  Editor  and  translator  of 
Jahr's  New  Manual,  Dr.  Hering  says  :  *  "  After  comparison 
of  the  translation  with  the  original,  the  above  indorsement 
is  hereby  altogether  and  completely  withdrawn."2  Thus, 
in  an  obscure  foot-note  in  a  German  periodical,  seen  by  not 
more  than  one  in  a  hundred  of  those  American  and  English 
students  who  are  induced  by  Dr.  Hering's  commendatory 
preface  to  place  confidence  in  Dr.  Hempel's  translations 
and  compilations,  Dr.  Hering  vindicates  his  fame  as  a  good 
scholar  and  a  faithful  champion  of  our  science  by  withdraw- 
ing his  commendation  of  Dr.  Hempel. 

If  those  whose  confidence  has  been  misplaced  by  reason 
of  this  indorsement  in  English,  canceled  in  German  only, 
should,  with  a  measure  of  just  indignation,  demand  of  me 
why  the  retraction  was  not  made  in  the  language  and  in  the 
country  in  which  the  commendation  was  suffered  to  be  pub- 
lished,—  why  Drs.  Hering  and  Gray,  acknowledged  leaders 
of  our  school  in  America,  did  not  suppress  this  so-called 
translation  or  expose  its  false  pretensions,  in  words  as  intel- 
ligible and  as  widely  read  as  those  in  which  their  support 
of  it  was  permitted, — alas!  I  have  nothing  to  say.  (See 
Appendix.) 

To  plead  that,  in  a  matter  which  involves  the  education 
or  perversion  of  a  whole  generation  and  the  healthy  progress 

1  Vol.  XL,  Nos.  23  and  24,  Feb-  z  Dies  wird  hiermit  nach  Vergleich- 
ruary  and  March,  1851.  ung  der  Uebersetzung  mit  dem  Orig- 

inal ganz  und  gar  zuruckgenommen. 


THE   SCIENCE   OF   THERAPEUTICS.  45 

and  soundness  of  Homoeopathy  wherever  the  English 
language  is  spoken, —  in  such  a  matter  the  engrossments  of 
business  or  tenderness  toward  a  delinquent  individual  kept 
them  silent,  would  be  to  cast  a  doubt  upon  the  estimate  in 
which  they  hold  scientific  truth,  a  doubt  inadmissible  in 
gentlemen  of  their  position. 

It  avails  not  to  say  :  Why  find  fault  with  these  translations 
and  this  manual,  inasmuch  as  we  have  no  others  ?  Had  the 
unworthiness  of  these  been  made  known,  had  they  not,  on 
the  contrary,  been  indorsed  by  high  authority,  we  had  long 
since  had  others  and  trustworthy.  An  exposure  of  the 
imperfections  we  have  spoken  of  would  have  created  a 
demand  for  other  works,  and  it  is  not  less  true  in  science 
than  in  trade  that  "demand  creates  a  supply." 

Having  selected  a  remedy  on  which  to  commence  his 
studies,  the  student  should  gather  together  all  the  reports  of 
provers,  whether  in  the  form  of  their  daily  records  (in  which 
form  our  dear  and  lamented  colleague  Dr.  Joslin  published 
his  admirable  proving  of  Rumex  crispus,  as  did  also  the 
Austrian  provers),  or  in  the  Hahnemannian  anatomical 
scheme,  and  should  carefully  peruse  them.  We  will  assume 
that  he  has  selected  Pulsatilla,  and  will  use  this  remedy  to 
illustrate  what  we  have  further  to  say.  We  have  no  other 
proving  of  this  drug  than  the  very  perfect  one  of  Hahnemann 
in  vol.  i.  of  Materia  Medico,  Pura. 

During  the  first  perusal,  —  and  several  may  be  necessary 
for  the  purpose, — the  student  should  endeavor  to  make  a 
general  analysis  of  the  proving.  This  analysis  would  enable 
him  to  place  the  drug  along  with  several  others  in  one  or 
other  of  certain  groups  into  which  he  will  find,  as  he 
advances  in  his  studies,  the  Materia  Medica  arranges  itself. 
Among  the  chief  points  of  this  general  analysis  will  be  the 
following : 

I.  Sphere  of  action  in  the  drug.  It  will  be  seen  that  every 
drug  affects  some  organs  or  systems  of  organs  or  tissues 


46  HOMCEOPATHY 

more  decidedly  than  others.  Pulsatilla,  for  example,  acts 
pre-eminently  upon  the  vegetative  system,  upon  the  organs 
of  reproduction  and  their  appendages,  and  upon  the  com- 
position of  the  blood,  depressing  the  action  of  the  former 
systems  and  producing  in  the  latter  a  condition  similar  to 
that  of  one  form  of  chlorosis.  We  learn  these  facts  by 
bringing  a  knowledge  of  Physiology  to  bear  upon  and 
interpret  the  symptoms  of  the  intestinal  tract  and  of  the 
urino-genital  organs,  those  of  the  vascular  system  and  the 
symptoms  of  the  head  and  disposition.  For  in  these  we 
have  retarded  digestion,  vertigo,  audible  pulsation  of  the 
carotids,  momentary  loss  of  sight  and  hearing  on  sudden 
exertion,  palpitation,  paleness,  retarded  and  scanty  menstru- 
ation with  syncope  and  exhaustion ;  depressed  melancholic 
disposition.  On  the  other  hand,  the  student  will  notice  that 
Pulsatilla  exerts  but  little  action  upon  the  bones,  skin  and 
glands,  and  this  will  be  another  important  step  toward 
grouping. 

II.  The  extent  to  whicJi  the  organic  substance  is  affected. 
From  some  provings  it  must  be  gathered  —  Spigelia,  for 
example — that  the  organic  substance  is  but  slightly  affected 
or  only  in  isolated  localities,  while  in  other  provings  the 
effect  is  profound  and  general, —  Carbo  vegetabilis  and 
Lachesis.  In  others,  again,  the  affection  of  the  organic 
substance  and  the  irritation  of  the  nervous  system  are  equal 
in  degree  and  both  are  great, —  Arsenicum.  Conclusions  on 
this  head  are  drawn  from  the  following  symptoms :  those  of 
the  complexion  and  of  the  skin  generally,  as  regards  color 
and  temperature,  which  enlighten  us  respecting  congestions, 
if  there  be  any,  and  the  color  and  character  of  the  congesting 
fluid ;  those  of  the  evacuations  from  the  bowels,  bladder, 
uterus  and  all  secreting  glands  and  surfaces;  those  of  the 
cutaneous  eruptions  and  ulcers ;  finally,  those  which  denote 
the  existence  of  dyscrasias  of  whatever  variety,  e.g.,  dropsies, 
phthisis,  cancer,  gout,  rheumatism,  etc.  Under  this  head 
we  find  in  the  proving  of  Pulsatilla  no  evidence  of  any 


THE   SCIENCE   OF   THERAPEUTICS.  47 

further  action  than  that  above  mentioned — a  hydrsemic 
dyscrasia  and  which  is  further  corroborated  by  the  abundant 
serous  or  thin  mucous  discharges  from  secreting  glands  and 
surfaces. 

III.  The  action  of  the  drug  on  the  vital  power,  correlative 
of  the  above,  and  shown  in  the  symptoms  of  the  nervous 
system  as  they  are  given  conjointly  with  the  symptoms  of  the 
various  organs  to  which  the  different  parts  of  the  nervous 
system  are  distributed.  He  may  consider  the  nervous  system 
under  five  heads,  a.  The  sensorium,  of  which  the  symptoms 
are  found  chiefly  under  the  rubrics  Head  and  Disposition. 
b.  The  general  sensibility,  c.  The  general  mobility.  Data 
respecting  these  heads  are  found  in  the  symptoms  of  the 
tissues  to  which  the  nerves  of  sense  and  motion  are  distrib- 
uted, d.  The  special  sensibility,  as  exhibited  in  the  symp- 
toms of  the  organs  of  special  sense — the  eye,  ear,  nose  and 
tongue,  e.  The  sympathetic  system — as  exhibited  in  the 
symptoms  of  organs  containing  involuntary  muscles — in  the 
intestinal  tract  and  in  all  the  sphincters. 

In  forming  conclusions  on  any  one  of  these  points,  regard 
must  be  had  to  the  entire  remaining  action  of  the  drug.  We 
should  otherwise  reach  a  very  false  judgment.  Pulsatilla, 
for  example,  produces  blindness  and  deafness.  We  might 
regard  these  as  very  important  affections  of  the  special 
senses,  did  we  not  learn  also  that  these  phenomena  occur 
simultaneously  with  scanty  and  difficult  menstruation,  and 
with  palpitation  and  throbbing  of  the  carotids,  and  conjointly 
with  great  pallor  and  frequent  syncope.  These  concurrences 
compel  us  to  regard  the  blindness  and  deafness  as  sympa- 
thetic symptoms  occurring  in  a  chlorotic  patient,  and  con- 
nected perhaps  with  a  hydraemia  produced  by  Pulsatilla. 

These  three  sections  of  a  general  analysis  having  been 
elaborated  during  a  first  perusal,  the  student  will  already  be 
in  a  position  to  arrange  many  drugs  in  groups  by  their  simi- 
larities and  differences  in  these  respects.  He  will  note,  for 
example,  that  in  their  sphere  of  action  Pulsatilla  and  Nux 


48  HOMCEOPATHY 

vomica  are  closely  allied,  while  again  they  differ  widely  in 
their  mode  of  action  both  on  the  organic  substance  and  on 
the  vital  power,  etc. 

The  practical  use  of  such  an  analysis  is  this :  that  when 
such  fundamental  facts  are  known  of  two  or  more  drugs,  it  is 
enough  to  have  clearly  in  mind,  in  any  case  of  disease,  what 
are  the  effects  of  the  disease  in  these  three  fundamental 
respects.  If,  then,  the  action,  for  example,  on  the  organic 
substance  be  similar  to  what  we  have  seen  to  be  the  effect 
of  Pulsatilla,  there  can  be  no  possibility  of  Nux  vomica  being 
applicable  in  the  case  and  no  need,  therefore,  of  studying  that 
drug  further  for  the  case.  This  process  of  elimination  by 
means  of  a  general  analysis  may  be  relied  on  wherever  we 
have  good  and  complete  provings  of  drugs,  and  where  the 
case  of  disease  presents  clear  and  definite  symptoms. 
When  we  are  dealing  with  fragmentary  provings  and  obscure 
cases  it  is  of  course  not  practicable. 

As  further  examples,  we  may  adduce  the  following  :  Spi- 
gelia  and  Silicea  both  affect  the  special  senses  remarkably  and 
similarly ;  yet  they  are  extremely  different  in  their  action  on 
the  organic  substance.  Hyoscyamus  and  Carbo  vegetabilis 
affect  the  sphincters  similarly,  though  in  other  respects  so 
unlike. 

After  thus  generalizing  in  a  comprehensive  way,  the 
student  will  observe  certain  phenomena  of  a  more  special 
character ;  for  example,  that  among  the  variety  of  sensations 
recorded  as  having  been  produced  by  the  drug,  there  is  a 
certain  uniformity  in  general  character  throughout  most  of 
the  organs  affected.  But  here  he  meets  difficulties  arising 
from  inaccuracy  of  provers,  or  rather  from  the  fact  that,  all 
descriptions  of  sensations  being  clothed  in  figurative  lan- 
guage, the  imaginations  of  different  provers  suggest  to  them 
different  modes  of  expression.  The  wealth  of  the  German 
language  in  synonyms  has  not  diminished  this  difficulty.  An 
approximate  analysis  of  sensations  such  as  has  been  made 
by  Dr.  Dudgeon  would  be  of  service  in  this  regard.  The 


THE   SCIENCE   OF  THERAPEUTICS.  49 

Individuality  of  some  drugs  is  much  more  strongly  marked 
than  that  of  others  by  this  feature  of  their  effects,  and  pro 
tanto,  it  serves  as  their  characteristic.  Thus  Bryonia  and 
Squilla  are  distinguished  by  sticking,  and  Arsenicum  by 
burning,  pains. 

Another  point  to  be  noted,  and  which  may  serve  still 
further  to  individualize  the  drug,  is  periodicity,  which  in 
many  drugs  is  well  marked  and  of  a  definite  type;  e.g., 
Arsenium,  Ipecacuanha,  Natrum  muriaticum,  Nux  vomica. 
In  Pulsatilla  it  is  very  marked,  but  the  type  is  not  constant. 

But,  perhaps,  the  most  important  of  all  the  considerations 
in  which  resides  the  individuality  of  a  drug  are  the  condi- 
tions and  concomitants  of  the  symptoms.  The  conditions 
are  the  phenomena  of  time,  place,  and  circumstance  on 
which  the  symptoms  depend.  For  example,  Pulsatilla  pro- 
duces tearing  pain  in  the  hip.  So  do  several  drugs,  but 
that  of  Pulsatilla  occurs  in  the  afternoon, —  condition  of 
time;  it  occurs  and  is  aggravated  in  a  warm  room, —  con- 
dition of  place ;  occurs  during  and  is  aggravated  by  repose, 
—  condition  of  circumstance.  A  concurrence  of  this  phe- 
nomenon and  these  conditions  is  found  only  under  Pulsatilla. 
Here  these  conditions  are  the  characteristic.  The  concomi- 
tants are  those  phenomena,  whether  we  call  them  sympa- 
thetic or  secondary,  which  always  accompany  any  symptom 
or  group  of  symptoms.  Absence  of  thirst  is  a  concomitant 
of  many  groups  of  symptoms  under  Pulsatilla.  So  likewise 
are  chilliness,  cold  feet,  wakefulness  in  the  evening  and 
sleepiness  in  the  morning,  etc.  Nux  vomica  has  the 
reverse.  So  is  cold  sweat  of  the  forehead  under  Veratrum. 

Having  thus  made  a  general  analysis  of  the  proving, 
obtaining,  first,  a  general  view  of  the  action  of  the  drug  on 
the  great  divisions  of  the  organism  and  of  the  pathological 
conditions  which  it  produces  ;  and,  second,  a  general  view  of 
the  characteristics  of  its  action,  the  student  may  proceed  to 
a  special  analysis,  which  will  involve  a  similar  study  of  the 
action  of  the  drug  on  each  organ  and  anatomical  region  of 
5 


50  HOMOEOPATHY 

the  body.     In  this  he   cannot  do  better  than  follow  the 
Hahnemannian  scheme. 

The  points  to  be  considered  in  each  region  and  under  each 
rubric  are  the  following :  The  organic  changes ;  the  sensa- 
tions,— their  nature,  locality  and  direction ;  the  conditions 
of  time,  place  and  circumstance,  and  the  concomitants.  Thus, 
for  example,  in  studying  the  Head,  he  may  consider : 

a.  The  SENSORIUM,  under  which  the  subdivisions  may 
be: 

1.  Vertigo,  its  nature,  conditions  of  time,  place  and  cir- 
cumstance, and  its  concomitants.     Thus,  the  vertigo  of  Pul- 
satilla  is  a  staggering ;  it  occurs  after  eating,  in  a  warm  room, 
and  during  repose   (there  is  a  rare    alternate  effect)  ;    the 
concomitants  are  heaviness    in  head  on  stooping,  paleness- 
and  internal  heat  in  the  head. 

2.  Intelligence,  with  conditions  and  concomitants  as  above, 
j.  Memory, 

4..  Illusions  of  the  imagination, 

b.  HEADACHE,  under  which  the  points  to  be  noted  are  : 
/.  Character  of  the  pain. 

2.  Locality. 

j.   Its  course  if  it  move. 

^.  Conditions  and  concomitants  as  above. 

c.  THE  ORGANIC  CHANGES,  which  are  to  be  studied  in 
the  same  way.     These  comprise  all  objective  and  material 
phenomena. 

In  this  manner,  the  student  will  examine  the  effect  of  the 
drug  upon  each  organ  and  tissue  of  the  body,  as  will  be  more 
clearly  shown  by  a  scheme  for  the  study  of  the  Materia 
Medica  which  will  be  appended  to  this  essay. 

The  result  will  be  an  accurate  knowledge  of  the  action  of 


THE   SCIENCE   OF  THERAPEUTICS.  51 

the  drug,  in  so  far  as  the  proving  is  complete,  upon  the 
whole  organism  in  general  and  in  detail.  The  special 
analysis  will  serve  to  correct  certain  errors  into  which  the 
general  analysis  might  lead  the  practitioner.  Conditions  are 
not  always  uniform  for  all  the  organs.  Thus,  although  the 
general  conditions  of  Pulsatilla  are  occurrence  and  aggrava- 
tion in  the  afternoon  and  evening,  during  repose  and  by 
heat,  with  relief  by  motion  and  cold,  and  must  be  so  stated 
in  a  general  analysis,  yet  there  are  a  few  special  symptoms 
to  which  the  opposite  conditions  attach,  and  this  fact  is 
brought  out  by  the  special  analysis. 

The  study  of  a  proving  to  be  practically  available  must  be 
comparative.  After  ascertaining  the  properties  of  each  drug 
by  positive  investigation  and  analysis,  in  the  manner  detailed, 
the  next  step  is  to  ascertain  what  drugs  resemble  it,  and  in 
what  features  they  are  like  and  how  they  differ.  To  make 
such  a  comparison  as  this  in  studying  the  Materia  Medica,  a 
repertory  is  indispensable,  and  this  need  alone,  if  a  repertory 
were  not  equally  indispensable  in  daily  practice,  would  be  a 
sufficient  reply  to  those  who  idly  talk  about  such  a  work 
being  superfluous  or  mischievous. 

Such  is  a  method  of  studying  the  Materia  Medica  which, 
after  much  reflection  and  trial  of  various  plans,  I  venture  with 
unfeigned  diffidence  to  unfold.  It  is  elaborate  and  requires 
a  wearying  application  which  those  alone  can  appreciate  who 
have  engaged  in  similar  tasks.  To  complete  such  a  sys- 
tematic study,  even  in  comparative  leisure,  might  require 
seven  years  of  unremitting  labor — just  the  period  for  which 
a  lad  is  apprenticed  to  learn  his  trade.  Should  we  shrink 
from  devoting  so  long  a  time  to  the  mastery  of  the  most 
complex  and  difficult,  and  the  noblest  science  and  art  which 
are  possible  to  man  on  earth  ? 

I  desire  to  add  a  few  words  of  a  practical  nature.  Pre- 
scribers  are  liable  to  two  errors  of  an  opposite  kind;  the 
possibility  of  which  will  be  apparent  from  what  has  been 
written. 


52  HOMOEOPATHY 

The  one  consists  in  prescribing  from  a  general  analysis  of 
drugs  without  regard  to  the  characteristics  which  individual- 
ize them.  This  is  equivalent  to  prescribing  any  member 
indifferently  of  a  whole  group  of  drugs,  and  necessitates  a 
corresponding  generalizing  view  of  disease.  It  is  the  method 
of  the  Old  School  which  seeks  to  arrange  drugs  and  diseases 
in  groups  and  which  ignores  characteristics  and  individuals. 
The  other  error  consists  in  prescribing  on  the  strength  of  one 
or  two  characteristics  which  maybe  detected,  without  however 
examining  whether  the  general  effects  of  the  drug  correspond 
to  the  general  features  of  the  disease.  Now,  characteristics, 
for  the  most  part,  as  we  have  seen,  derive  their  value  from 
their  association  as  concomitants  or  conditions  with  some 
symptom  which  is  not  in  itself  a  characteristic.  Discon- 
nected from  this,  they  are  as  void  of  significance  as  a  man's 
nose  would  be  if  cut  off  from  his  face,  though  while  on  his 
face  it  might  have  been  the  chief  feature  by  which  his  friends 
recognize  him.  I  will  not  deny  that  by  this  method,  great 
successes,  "lucky  hits"  I  would  call  them,  are  sometimes 
made.  But  I  do  stoutly  affirm  that  atrocious  and  inexcus- 
able blunders  are  much  more  frequently  the  result. 

I  admit,  too,  that  in  certain  cases  of  disease  there  is  no 
possibility  of  making  such  an  analysis  as  we  have  advised, 
and  that  certain  drugs  are  so  incompletely  proved  that  we 
know  of  them  only  one  or  two  characteristic  symptoms  and 
Cannot  study  them  as  recommended.  All  that  can  be  said 
of  such  cases  is  that  they  are  incomplete  and  come  under  no 
rule.  We  must  do  the  best  we  can  and  adopt  a  defective 
method,  which  is  nevertheless  sometimes  successful  rather 
than  make  no  attempt  to  cure.  Better  cure  by  a  "  lucky 
hit"  than  not  at  all.  But  let  not  this  lead  us  astray  where 
we  might  do  better. 

If  one  had  to  traverse  a  wilderness  he  would  desire  first  of 
all  a  compass.  If  this  were  not  to  be  had  he  might  "  steer 
by  the  stars."  If  these  were  obscured  he  might  judge  from 
the  direction  of  vegetation  and  of  hills  and  rivers.  Failing 


THE   SCIENCE   OF   THERAPEUTICS.  53 

these,  he  might  even  "  guess"  and  his  guess  might  lead  him 
right.  Nevertheless,  few  travelers  of  sound  mind  would  be 
led  by  such  a  success  to  prefer  a  "guess  "  to  a  "compass." 

A  SCHEME  FOR  THE  STUDY  OF  MATERIA  MEDICA. — In 
the  hope  that  what  has  been  written  may  serve  not  only  to 
explain  the  method  in  which  I  have  thought  the  study  of 
Materia  Medica  may  be  best  pursued,  but  also  to  assist  those 
who  are  entering  upon  that  arduous  study,  I  publish  here- 
with a  schedule  drawn  up  originally  for  my  own  guidance, 
and  which,  I  think,  was  a  great  assistance  to  me. 

A.-^GENERAL    ANALYSIS. 

1.  ACTION  ON  THE  VITAL  POWER — as  exhibited  in  the 
action   of  the   remedy  upon — a.  The   sensorium ;    b.  The 
special  senses ;  c.  The  sphincters ;  d.  The  other  involuntary 
muscles ;  e.  The  power  of  locomotion. 

2.  ACTION  ON  THE  ORGANIC  SUBSTANCE  ;  as  exhibited 
in  a.  The  complexion  (showing,   viz. :  the  state  of  vessels 
and  the  nature  of  their  contents)  ;  b.  The  evacuations ;  c. 
Ulcers,  if  any  which  previously  existed  are  modified  by  the 
remedy  or  if  any  are  produced  by  the  remedy ;  d.  Erup- 
tions; e.  General  affections  of  a  dyscrasic  nature,  such  as 
dropsy,  tuberculosis,  etc.,  etc. 

3.  THE  SPHERE  OF  ACTION  OF  THE  REMEDY.    What 
organs  or  systems  of  the  body  are  affected  in  a  general  way 
and  in  what  order  they  are  affected. 

4.  SENSATIONS.     What  kind  of  sensations  predominate 
among  those  ascribed  to  the  remedy  in  the  proving,  and 
what  relation,    if   any,    appears   to    exist    between   certain 
varieties    of   sensation    and    certain   classes   of   organs    or 
tissues. 

5.  PERIODICITY.    If  there  be  any  periodicity  in  the  symp- 
toms it  is  to  be  particularly  noted  and  its  character  denned. 


54  HOMOEOPATHY 

• 

6.  PECULIARITIES.     There  are  few  good  provings  which 
do  not  ascribe  to  the  remedy  certain  peculiarities  of  action 
which  are  incapable  of  classification,  which  run  through  the 
whole  action  of  the  remedy  and  which  are  peculiar  to  one 
remedy  and  are  therefore  important  characteristics. 

These  peculiarities  constitute  the  conditions  of  time,  cir- 
cumstance, aggravation  and  concomitance,  which  are  attached 
to  the  symptoms  and  often  give  individual  character  to  them 
as  belonging  to  one  remedy  in  particular,  and  as  incapable 
of  being  ascribed  in  mass  to  any  other  drug.  A  symptom 
being  recorded  as  produced,  for  example,  by  Pulsatilla,  the 
questions  "When  did  it  occur?"  "When  was  it  aggra- 
vated?" "When  was  it  ameliorated?"'  "When  did  it 
cease?"  give  the  condition  of  time  which  attach  to  that 
symptom.  In  like  manner  the  questions  "  Under  what  cir- 
cumstances (viz.,  of  rest  or  motion,  of  heat  or  cold,  etc., 
etc.)  did  it  occur,  was  it  aggravated,  was  it  ameliorated," 
give  the  conditions  of  circumstance  and  aggravation  which 
attach  to  the  symptom. 

It  will  be  observed  of  almost  every  remedy  that  certain 
symptoms  or  series  of  symptoms  are  accompanied  by  one 
or  several  other  symptoms.  This  fact  is  the  condition  of 
concomitance  to  which  we  refer.  For  example,  many  symp- 
toms of  Pulsatilla  are  accompanied  by  a  disposition  to 
weep,  of  Nux  vomica  by  fugitive  chills,  of  Arsenicum  by 
inordinate  weakness,  of  Veratrum  by  cold  sweat  of  the 
forehead,  etc. 

It  is  further  noticeable  that  in  the  provings  of  some  drugs 
this  concomitance  of  symptoms  by  other  symptoms  is 
strongly  marked,  and  almost  universal  as  in  the  case  of 
Arsenicum. 

7.  RESUM^  OF  THE  CHARACTERISTICS  OF  THE  REMEDY. 
This  will  include  everything  in  the  above  analysis  which  is 
shown  by  a  comparative  study  of  other  drugs  to  be  peculiar 
to  it.     It  will  comprise  in  particular  the  conditions  of  time, 
circumstance,  aggravation  and  concomitance,  and  the  periods 
of  the  day  at  which  the  action  of  the  drugs  is  most  marked. 


THE   SCIENCE   OF  THERAPEUTICS.  55 

B.— SPECIAL    ANALYSIS. 

1.  HEAD. 

a.  Sensorium,  comprising  the  subdivisions :    I .  Vertigo ; 
•2.   Intelligence ;    3.   Memory ;    4.   Illusions.     Each  of  these 
subdivisions  is  to  be  studied  in  respect  of  sensations  in  so 
far  as  they  can  be  predicated  of  it ;  of  periodicity  ;  of  con- 
ditions of  time,  circumstance,  aggravation  and  amelioration  ; 
and  of  concomitance.     And  under  the  latter  rubric  it  is  to  be 
especially  inquired  what  symptoms  affecting  other  organs,  or 
systems,  occur  simultaneously  in  evident  physiological  con- 
nection with  the  symptom  under  consideration. 

b.  Headache.     The  points  to  be  investigated  are :   I .  The 
location  of  the  pain  if  it  be  stationary  —  its  course  if  it  move; 
2.  The  sensation ;  3.  The  conditions  of  time,  circumstance, 
aggravation  and  amelioration,  as  above  explained  in  detail  > 
4.   Concomitance. 

c.  Organic  changes.     These  affect  the  material  substances 
and  tissues  of  the  head,  and  comprise  all  deviations  from  a 
normal    material  condition  of  which  we    can    in  any  way 
become    cognizant — affections,    for   example,   of  the   skin, 
glands,  vessels,  organs  of  special  sense,  etc. 

2.  EYES. 

a.  The    Orbit.      I.  Location;    2.   Sensations;    3.   Condi- 
tions; 4.  Concomitance;  5.   Organic  changes.     These  sub- 
divisions here  and  throughout  the  scheme,  wherever  used, 
are  to  be  understood  and  studied  as  already  explained  in  the 
general  analysis  and  under  the  title  "  Head." 

b.  Lids.     I.  Location;   2.   Sensation;    3.  Conditions;   4. 
Concomitance;  5.  Organic  changes. 

c.  Conjunctiva,      i.  Location;    2.  Sensations;    3.  Condi- 
tions; 4.  Concomitance;  5.  Organic  changes. 

d.  Globe.      I.   Location;    2.   Sensations;    3.    Conditions; 
4.  Concomitance;  5.  Organic  changes. 


56  HOMCEOPATHY 

e.  Secretions,     i.    Character,    as   regards  color,   acridity, 
quantity,  etc.  ;  2.  Conditions ;  3.   Concomitance. 

f.  Special  sense.      i.  Vision,   altered,   intensified,   dimin- 
ished, or  perverted.     2.    Conditions  attached  to  such  altera- 
tion ;  3.  Concomitance. 

N.  B.  After  each  such  study  of  a  single  organ,  a  physio- 
logical estimate  should  be  made  of  the  significance  of  the 
symptoms.  For  this  purpose  a  faithful  study  of  the  con- 
comitance is  of  inestimable  value.  For  example,  the  proving 
of  Pulsatilla  gives  sudden  loss  of  vision.  Is  this  Amaurosis  ? 
The  concomitance  shows  that  the  loss  of  vision  is  accom- 
panied by  loss  of  hearing,  by  syncope,  and  occurs  at  a 
period  of  menstrual  irregularities.  The  symptom  is  at  once 
explained.  This  is  only  a  very  obvious  instance  of  what  is 
not  always  an  easy  though  always  a  most  necessary  task. 

j.  EARS. 

a.  External  Ear.     i.  Location;   2.  Sensations,  3.  Con- 
ditions;   4.  Concomitance;    5.  Organic  changes. 

b.  Internal  Ear.      I.  Location;    2.   Sensations;    3.   Con- 
ditions;   4.  Concomitance;    5.   Organic  changes  (as  secre- 
tions, etc.)  and  their  conditions. 

c.  Special    sense.       I.     Deviations,    whether    intensified, 
diminished   or    perverted ;     2.    Conditions ;     3.    Concomi- 
tance. 

4.  NOSE.    i.  Location;  2.  Sensations;  3.  Organic  changes, 
including  secretions.     With  reference  to  each  of  the  above, 
observe,  a.  The  conditions ;    b.  The  concomitance. 

Special  sense  of  smell,  i.  Deviations  from  a  normal  con- 
dition; 2.  Conditions;  3.  Concomitance. 

5.  FACE.      I.   Location;    2.   Complexion;  3.   Sensations; 
4.   Temperature;     5.   Organic    changes.       As  regards  each 
of   these   subdivisions,   study,   a.   The    conditions ;     b.   The 
concomitance. 


THE   SCIENCE   OF  THERAPEUTICS.  57 

6.  LIPS.    I.    Location;    2.    Aspect;    3.    Sensations;    4. 
Temperature;    5.  Organic  changes.     Respecting  each  sub- 
division, note,  a.  The  conditions ;  b.  The  concomitance. 

7.  GUMS  AND  TEETH,      i.  Location;    2.  Sensations;    3. 
Organic  changes.     In  reference  to  each  subdivision,  note,  a. 
The  conditions ;  b.  The  concomitance. 

8.  MOUTH,     i.    Location;    2.    Sensations;    3.    Organic 
changes.     Of  these,  a.  The  conditions ;  b.  Concomitance. 

p.  TASTE,  i.  Deviation  from  normal  state,  a.  Condi- 
tions ;  b.  Concomitance. 

10.  TONGUE,     i.  Location;    2.  Sensations;  3.  Aspect; 
4.   Organic  changes.     Of  these,  a.  The  conditions ;  b.  The 
concomitance. 

11.  THROAT  AND  FAUCES,      i.  Location;   2.  Sensations; 
3.  Aspect;  4.  Organic  changes  (including  tumefaction,  secre- 
tion, deposits,   etc.).       Respecting  these  divisions,    a.    The 
conditions ;    b.  The  concomitance. 

12.  OESOPHAGUS,    i.  Location;  2.  Sensations ;  3.  Organic 
changes ;  4.  Special  function.     Of  these,  a.  The  conditions ; 
b.  The  concomitance. 

zj.  STOMACH,  i.  Location;  2.  Sensations;  3.  Organic 
changes ;  4.  Special  function  modified,  as  respects,  a.  Appe- 
tite ;  b.  Thirst ;  and  these  modifications  may  be  exaltation, 
diminution  or  perversion ;  c.  Nausea ;  d.  Vomiting.  Re- 
specting these  divisions  and  subdivisions,  observe,  a.  The 
conditions  ;  b.  The  concomitance. 

14.  HYPOCHONDRIA,  i.  Right,  2.  Left.  As  regards  each, 
study,  I.  Location;  2.  Sensations;  3.  Organic  changes.  As 
regards  each  subdivision,  observe,  a.  The  conditions;  b. 
The  concomitance. 

(Here  and  wherever  the  rubric  comprises  a  region  which 
contains  a  number  of  organs,  endeavor  to  make  by  the  aid 
of  the  sciences  of  Physiology  and  Pathology  a  rational 


58  HOMOEOPATHY 

appreciation  of  the  organs  involved,  and  in  this  study,  pay 
especial  regard  to  the  concomitance,  in  order  to  gain  the 
full  physiological  significance  of  the  symptoms.  For  exam- 
ple, in  affections  of  the  right  hypochondrium  where  the  liver 
may  be  supposed  to  be  implicated,  the  concomitance  will 
justify  the  supposition  if  it  show  simultaneous  and  corre- 
sponding symptoms  of  the  tongue,  stomach,  head,  stool, 
skin,  back,  etc.,  etc.  So  of  the  left  hypochondrium  and  the 
uterine  system.) 

75.  ABDOMEN.  I.  Location  with  appreciation  of  the 
organs  involved;  2.  Sensations;  3.  Organic  changes. 
Respecting  these  divisions,  note,  a.  The  conditions ;  b.  The 
concomitance. 

16.  STOOL.  I.  Sensations,  their  character,  location  and 
course,  a.  Before  stool ;  b.  During  stool ;  c.  After  stool. 
As  regards  these  three  subdivisions,  note,  a.  The  conditions  ; 
b.  The  concomitance.  2.  Organic  phenomena,  viz.,  color, 
odor,  consistence,  composition,  e.  g. — digested  or  not — 
consisting  of  faeces  alone  or  combined,  etc. 

77.  ANUS  AND  RECTUM.  I.  Location;  2.  Sensations; 
3.  Organic  changes  (including  secretions,  tumors,  condylo- 
mata,  etc.,  etc.).  Respecting  all  of  these  divisions,  note,  a. 
The  conditions ;  b.  The  concomitance. 

18.  URINARY  ORGANS. 

a.  Bladder.     i.    Location;    2.    Sensations;    3.    Organic 
changes. 

b.  Urethra.      I.    Location;    2.    Sensations;    3.    Organic 
changes. 

c.  Kidneys.      i.    Location;    2.    Sensations;    3.    Organic 
changes. 

d.  Ureters.      I.    Location;    2.    Sensations;    3.    Organic 
changes. 

With  regard  to  all  of  these  divisions,  under  each  of  these 
organs,  study,  a.  The  conditions ;  b.  The  concomitance. 


THE   SCIENCE   OF  THERAPEUTICS.  59 

e.  Urine,     i.   Quantity;    2.  Color — physical  properties; 
3.  Odor;  4.  Deposits. 

f.  Micturition.     I.  Frequency;  2.   Sensations.     Note,    a. 
Conditions;  b.  Concomitance. 

19.  GENITAL  ORGANS — Male. 

a.  Penis.       I.    Location;    2.    Sensations;    3.    Organic 
changes. 

b.  Testes.      I.    Location;    2.    Sensations;    3.    Organic 
changes. 

c.  Special  function.     I.  Modifications,  as  regards  exalta- 
tions, diminution,  or  perversion  ;  2.  Sensations. 

Respecting  these  divisions  and  subdivisions,  study  under 
each,  a.  The  conditions ;  b.  The  concomitance. 

d.  Secretion.      I.  Quantity;  2.   Quality,  admixture,  etc.; 
3.  Mode  of  evacuations,     a.  Conditions ;  b.  Concomitance. 

20.  GENITAL  ORGANS — Female. 

a.  Vulva.       I.    Location;    2.    Sensations;     3.    Organic 
changes. 

b.  Vagina.     I.    Location;    2.    Sensations;    3.    Organic 
changes ;  4.  Secretion,  considered  as  regards,  a.  Character ; 
b.  Quantity;  c.  Color. 

c.  Uterus.       I.     Location;    2.    Sensations;    3.    Organic 
changes  ;  4.  Secretions  considered  as  above. 

d.  Ovaries,     i.  Sensations;    2.  Organic  changes.     Under 
these  divisions  and  subdivisions,  note,    a.  The  conditions; 
b.  The  concomitance,  attaching  to  each. 

e.  Menstruation,     i.  Sensation;  2.  Periodicity;  3.  Quan- 
tity; 4.  Color;  5.  Consistence;  6.  Duration.     Under  these, 
a.  The  conditions ;  b.  The  concomitance. 

21.  RESPIRATORY  ORGANS. 

a.  Nasal  Mucous  Membrane,  i.  Location;  2.  Sensations ; 
3.  Organic  changes  ;  4.  Secretions,  as  regards  quantity  and 
quality.  Respecting  all  these,  a.  The  conditions;  b.  The 
concomitance. 


60  HOMOEOPATHY 

b.  Larynx  and  Trachea.     I.  Location;  2.  Sensations;  3. 
Organic  changes;  4.   Secretions  as  above.     Respecting  all 
these,  a.  The  conditions;  b.  The  concomitance. 

/.  Cough,  a.  Its  sound;  b.  Its  character,  as  paroxysmal 
or  otherwise,  dry  or  loose;  c.  Location  of  the  sensation  which 
provokes  it ;  d.  Conditions ;  e.  Concomitance. 

2.  Sputa,  i.  Character;  2.  Consistence;  3.  Color;  4. 
Smell ;  5.  Taste  ;  6.  Locality  from  which  it  appears  to  come ; 
7.  Mode  of  evacuation;  8.  Sensations  which  precede  and 
follow  its  evacuation ;  9.  Conditions;  10.  Concomitance. 

c.  Thorax — Internal.     I.  Location;  2.  Sensation;  3.  Or- 
ganic changes,     a.  Conditions ;  b.  Concomitance. 

— External.  I.  Location;  2.  Sensation;  3.  Organic 
changes  (including  mammae  and  nipples);  4.  Secretions. 
Respecting  the  above,  a.  Conditions;  b.  Concomitance. 

d.  Respiration.       I.    Sensations;     2.    Organic    action;     3^ 
Breath,  its  odor,  temperature,  volume.     Regarding  these,  a. 
The  conditions;  b.  Concomitance. 

22.  HEART. 

a.  Subjective.     I.  Location;  2.  Sensations. 

b.  Objective.     I.  Location;  2.  Organic  changes  as  shown 
by  position,  sounds,   magnitude  and  by  rational  signs ;  3. 
Pulsation.     Respecting  these  divisions,   a.   The  conditions; 
b.  The  concomitance. 

23.  BACK.      I.  Location,  dividing  the  back  into  regions 
from  below  upward  and  appreciating  the  organs  and  tissues 
involved,  as  well  as  the  concomitance  will  admit;  2.  Sensa- 
tions ;    3.  Organic   changes.     Under    these,   a.  Conditions ; 
b.  Concomitance. 

24.  UPPER  EXTREMITIES — RIGHT  AND   LEFT.      Re- 
specting each,  study 

i.  Articulations.  I.  Location  ;  2.  Sensations;  3.  Organic 
changes. 


THE  SCIENCE   OF  THERAPEUTICS.  6 1 

2.  Interarticular  Region,     i.  Locations;    2.    Sensations; 

3.  Organic  changes.     Respecting  all  of  these,  a.  Conditions ; 
b.  Concomitance. 

25.  LOWER  EXTREMITIES — RIGHT  AND  LEFT.    Studied 
in  all  respects  as  the  Upper  Extremities. 

As  regards  the  Extremities  generally,  note  Sensations  with 
their  course  (and  Duration)  if  they  be  wandering;  e.  g.,  from 
a  right  upper,  to  a  left  lower  extremity,  etc. 

26.  SLEEP.     I.  Character;   2.  Periods;  3.  Preceded  by; 

4.  Succeeded  by ;  6.  Concomitance. 

a.  Dreams.     I.  Conditions;  2.  Concomitance. 

2j.  FEVER,  as  a  paroxysm  made  up  of  stages. 

1.  Incomplete  Paroxysm,  consisting  of  only  one  or  of  two 
stages,      i.  Their  order;  2.  Relative  severity  and  duration ; 
3.  Antecedents ;  4.  Sequelae ;  5.  Conditions;    and,  6.  Con- 
comitance. 

2.  Complete  Paroxysm.      I.  Order  of  the  stages;  2.  Their 
relation  to  each  other.  Then  consider  the  separate  stages  ;  e.g. : 

a.  Chill,     i.  Character;    2.  Precursor;  3.  Succeeded  by; 
a.  Conditions ;  b.  Concomitance. 

b.  Fever,  as  a  single  stage,  or  Heat.     i.  Character;  2. 
Precursors  ;  3.  Sequelae,     a.  Condition  ;  b.  Concomitance. 

c.  Sweat,     i.  Character;    2.  Precursors;  3.  Sequelae,     a. 
Conditions;  b.    Concomitance. 

Between  chill  and  heat  and  heat  and  sweat,  study  the 

Interval,  i.  Character;  2.  Sensations;  3.  Conditions;  4. 
Concomitance.  Also  the  time 

After  the  paroxysm,  i.  Sensations;  2.  Conditions;  3. 
Concomitance. 

Pulse,     i.  Quality;  2.  Frequency;  3.  Conditions. 

28.  SKIN. 

i.  General,  i.  Sensations;  2.  Organic  changes ;  3.  Con- 
ditions ;  4.  Concomitance. 


62      HOMOEOPATHY  THE   SCIENCE   OF  THERAPEUTICS. 

2.  Special.       I.    Localities   affected;    2.    Sensations;    3. 
Organic  changes ;  4.  Conditions;  5.  Concomitance. 

3.  Organic  Changes.     Under  this  head  are  comprised  : 

1.  Eruptions.     I.  Aspect;  2.    Color;    3.   Sensations;    4. 
Secretions,     a.   Their  color ;  b.    Consistence ;    c.   Odor ;    d. 
Quality — e.g.,  acrid  or  bland,  etc.;    5.  Scabs,     a.  Quality; 
b.  Tenacity;  c.  Color;  d.  Odor;  e.  Conditions  of  subjacent 
tissues  or  secretions. 

2.  Ulcers.     To  be  studied  as  Eruptions. 

3.  Warts. 

4.  Tumors.     I.    Physical  properties;    2.   Sensations;    3. 
Conditions;  4.  Concomitance. 

29.  MIND. 

1.  Faculties  Modified,      i.    Exalted ;    2.    Depressed ;    3. 
Perverted.     Under  these,   a.  Conditions ;  b.  Concomitance. 

2.  Memory.     As  under  Faculties. 

jo.  DISPOSITION,      i.  Quality;    2.    Conditions;    3.  Con- 
comitance. 


APPENDIX. 


ANNOTATIONS  on  the  History  of  Homoeopathic  Literature  in  the  English 
Language.  Letter  from  Dr.  Lippe. 

Dr.  Carroll  Dunham  in  his  excellent  article  "  Homoeopathy  the  Science  of 
Therapeutics,"  published  in  the  AMERICAN  HOMCEOPATHIC  REVIEW,  after 
complaining  that  it  is  humiliating  to  be  compelled  to  say  that  there  are  no- 
trustworthy  manuals  of  our  Materia  Medica  in  the  English  language,  alludes  to- 
the  Preface  of  Jahr's  New  Manual  and  Symptomen  Codex,  by  Dr.  Constantine 
Hering,  and  refers  to  the  subsequent  publication  of  that  Preface  in  the  original 
German  manuscript,  in  the  Allg.  Horn.  Zeitung,  and  which  contains  also  the 
following  foot-note  by  Dr.  Hering :  "  After  comparison  of  the  translation  with 
the  original,  the  above  indorsement  is  hereby  altogether  and  completely  with- 
drawn.'? Dr.  Dunham  further  says  that  if  he  were  asked  why  this  retraction 
was  not  made  in  the  language  and  in  the  country  in  which  the  commendation 
was  suffered  to  be  published,  he  would  have  nothing  to  say.  Dr.  Dunham 
further  continues  :  "  It  avails  not  to  say,  why  find  fault  with  these  translations 
and  this  manual,  inasmuch  as  we  have  no  others  ?  Had  the  unworthiness  of 
these  been  made  known,  had  they  not,  on  the  contrary,  been  indorsed  by  high 
authority,  we  had  long  since  had  others  and  trustworthy.  An  exposure  of  the 
imperfections  we  have  spoken  of  would  have  created  a  demand  for  other  works, 
and  it  is  not  less  true  in  science  than  in  trade  that '  demand  creates  a  supply.'  " 

Dr.  D.  Wilson,  who  is  now  publishing  an  article  in  the  Monthly  Homoeopathic 
Review,  beginning  in  No.  7,  vol.  vi.,  headed  "  How  far  is  Dr.  Hempel  to  be 
trusted  as  a  translator  of  Hahnemann's  works,"  says,  in  that  number  :  "  Yet, 
strange  to  say,  no  one,  as  far  as  I  am  aware,  has  hitherto  publicly  pointed  out 
the  blunders  that  have  been  perpetrated  by  Dr.  Hempel  in  his  voluminous 
translations  of  Hahnemann's  works."  To  correct  the  above  erroneous  state- 
ments allow  me  then  to  publish  the  following  facts : 

JaAr's  New  Manual  and  Symptomen  Codex,  by  Dr.  C.  J.  Hempel,  vol.  iii., 
was  reviewed  by  me  for  the  Philadelphia  Journal  of  Homoeopathy,  in  1852,  in 
vol.  i.,  page  427  to  432,  my  name  not  appearing.  Dr.  Hempel  puts  in  a 
demurrer  in  vol.  i.,  page  467  to  476  of  the  same  Journal,  dated  December  I5th, 
1852.  In  vol.  i.,  page  518  to  521  of  that  Journal,  I  felt  compelled  as  the 
Author  of  the  Review  to  answer,  and  there  say :  "  I  write  (this  criticism)  for  the 
American  HomoaopathistSy  to  vindicate  ourselves  before  the  world,"  etc.  Dr. 
Hempel  answers  again,  February  24th,  1853,  vol.  i.,  page  549,  and  remarks 
that  the  interest  of  the  publisher  must  be  protected ;  he  then  appeals  to  the 
recommendations  of  Dr.  C.  Hering  in  the  preface  to  the  first  volume  of  the 


64  APPENDIX. 

work,  to  which  I  replied,  March  24th,  1853,  vol.  ii.,  page  59  to  6l,  vindicating 
Dr.  Hering  by  stating  that  he  could  not  then  publish  his  original  German 
preface  or  its  correct  translation,  nor  could  he  withdraw  his  recommendation 
in  the  country  in  which  that  commendation  was  published,  as  the  Homoeopathic 
Journal  then  published  was  in  the  hands  of  the  publisher  of  the  New  Manual, 
who  would  not  receive  and  circulate  communications  adverse  to  his  interests. 
I  further  then  gave  there  the  foot-note  of  Dr.  Hering  in  the  Allg.  Horn.  Zeitung, 
above  referred  to.  "After  comparing  the  translation  with  the  original,  I 
solemnly  withdraw  this  my  above  communication  and  indorsement." 

Dr.  Hempel  again  replied,  in  vol.  ii.,  pages  318  and  319,  declaring  me  to 
stand  convicted  of  libel,  threatening  legal  proceedings  or  demanding  an  arbitra- 
tion by  committee.  The  committee  report  of  the  24th  of  September  and  the 
8th  of  October,  1853,  is  published  in  vol.  ii.,  page  430,  and  this  committee, 
having  examined  Dr.  C.  Hering's  original  German  manuscript  of  the  preface 
to  the  New  Manual  and  its  publication  in  the  Allg.  Horn.  Zeitung,  with  the 
translation  by  Dr.  Hempel  as  published,  find,  that  the  point  assumed  by  me, 
viz.,  that  the  translation  of  Dr.  C.  Hering's  preface  to  the  New  Manual  and 
Symptomen  Codex  contained  willful  perversions  and  omissions,  has  been  estab- 
lished. A  reply  to  this  report  by  Dr.  C.  Hempel  is  published  in  vol.  ii.,  page 
573,  in  which  he  boldly  denies  that  he  is  guilty  of  any  essential  alterations. 
Later  the  publisher  succeeded  in  obtaining  by  some  means  the  names  of  a  few 
physicians  as  a  recommendation  to  the  Complete  Repertory. 

The  Review  was  published  ten  years  ago.  It  had  only  the  effect  to  procure 
for  Dr.  C.  J.  Hempel  a  professorship  in  the  Pennsylvania  College  of  Homoeop- 
athy. What  effect  his  teachings  and  publications  had  while  Professor  in  that 
Institute  are  well  known. 

That  ten  years  later  Dr.  Wilson,  in  England,  and  Dr.  Dunham,  in  the 
United  States,  should  indorse  my  review  of  1852  is  exceedingly  gratifying  to 
me,  but  unfortunately  does  not  remedy  the  evil  done  to  Homoeopathy  and  its 
progress  during  that  length  of  time. 

I  sincerely  hope  that  Drs.  Wilson  and  Dunham  will  be  more  successful  in 
1862  in  arousing  the  English-reading  members  of  the  profession  to  the  necessity 
of  accurate  translations  and  correct  versions  of  Hahnemann's  writings  and  our 
standard  works. 

AD.  LIPPE,  M.  D. 

Philadelphia,  December  7th,  1862. 

NOTE. — The  facts  respecting  the  publications  in  the  Philadelphia  Journal,  in 
1852-53,  are  essentially  as  above  stated  by  Dr.  Lippe.  The  reasons  why  they 
did  not  attract  general  attention  and  were  not  accepted  by  the  profession  as  a 
withdrawal  by  Dr.  Hering  of  his  strong  indorsement  of  Dr.  Hempel's  transla- 
tion of  the  Symptomen  Codex,  I  suppose  to  be  the  following : 

1.  The  first  paper  by  Dr.  Lippe  was  anonymous,   and  therefore  was  not 
authoritative  in  any  personal  sense. 

2.  The  foot-note  attached  by  Dr.  Hering  to  the  German  publication  of  his 
preface  was  not  quoted  by  Dr.  Lippe  until  after  a  succession  of  demurrers  by 
Dr.  Hempel  and  replications  by  himself  had  given  the  matter  the  aspect  of 
a  somewhat  personal  controversy ;  and  even  then  it  was  introduced  as  a  kind 


APPENDIX.  65 

of  obiter  dictum,  because  the  foot-note  referred  to  the  "  Symptomen  Codex  or 
New  Manual,"  in  two  volumes,  whereas  Dr.  Lippe's  review  had  treated  almost 
exclusively  of  the  Repertory,  or  vol.  iii. 

Now,  this  repertory  was  really  to  all  intents  and  purposes  not  so  much  a 
translation  as  a  new  work  by  Dr.  Hempel,  and  he  is  entitled  to  commendation 
or  adverse  criticism  according  to  the  merits  or  demerits  of  the  work,  as  an 
Author  rather  than  as  a  Translator.  In  such  a  capacity  Dr.  Hering's  foot-note 
and  preface  could  hardly  refer  to  him,  and  hence  the  foot-note,  introduced  "  by 
the  way,"  in  Dr.  Lippe's  letters  concerning  his  review  of  the  Repertory  failed 
to  attract  general  attention  and  to  vindicate  Dr.  Hering. 

But  the  above  "  annotations  "  are  entirely  satisfactory.  Coming,  as  they  do, 
from  a  confidential  friend  of  Dr.  Hering,  and  with  his  express  sanction  and 
approval,  they  are  a  complete  withdrawal  of  his  indorsement  of  the  English 
version  of  Jahr's  New  Manual.  They  give,  moreover,  a  satisfactory  reason 
why  this  withdrawal  could  not  have  been  published  at  an  earlier  date  in  this 
country,  viz. :  the  fact  that  the  publishing  interest  controlled  all  of  our  Journals 
from  the  year  1850  to  1858,  to  such  an  extent  that  nothing  in  the  shape  of  an 
adverse  criticism  of  any  important  publication  was  allowed  to  appear  in  any 
Journal.  This  statement  the  writer  can  corroborate  from  personal  experience. 

While  accepting  Dr.  Lippe's  annotations  as  full  and  satisfactory  on  these 
points,  I  am  not  disposed  to  adopt  unreservedly  his  criticisms  of  Dr.  Hempel. 
I  have  no  evidence  that  the  errors  and  omissions  which  render  it  impossible 
to  receive  his  works,  as  trustworthy  translations  of  the  books  they  profess  to 
represent,  are  willful  or  malicious.  I  think  they  may  be  all  accounted  for  by 
the  fact  that  the  translations  were  made  in  haste  and  therefore  carelessly,  and 
that  to  some  of  the  tasks  which  he  undertook  Dr.  Hempel  may  have  been,  at 
the  time,  hardly  competent.  And  when  we  consider  the  immense  amount  of 
labor  required  by  these  numerous  translations,  we  can  hardly  wonder  that 
errors  have  been  committed  and  omissions  made.  Unhappily,  this  does  not 
make  the  books  any  less  undeserving  of  confidence.  Of  course  an  error  or  an 
omission  is  just  as  fatal  to  the  trustworthiness  of  a  translation,  whether  it  be 
the  result  of  haste,  of  carelessness,  or  of  willful  perversion — but  the  interests  of 
science  do  not  require  the  critic  to  go  beyond  a  statement  of  the  fact  that  the 
work  is  not  trustworthy,  and  of  the  particulars  in  which  it  fails. 

In  my  remarks  on  Manuals  to  which  Dr.  Lippe  alludes,  I  refer  only  to  that 
part  of  the  New  Manual  which  relates  to  the  Materia  Medica.  The  faults  of 
the  English  version  of  the  preface,  however  provoking  to  the  Author  of  the 
preface,  have  not  the  same  kind  of  relation  to  the  general  interests  of  the 
science.  They  do,  however,  concern  the  personal  and  professional  reputation 
of  Dr.  Hering,  and  at  his  request  we  publish  a  letter  addressed  by  him  to  Dr. 
Gardiner,  Editor  of  the  Philadelphia  Journal  of  Homoeopathy  at  the  time  of  the 
publication  of  Dr.  Lippe's  Review  of  the  Repertory  before  alluded  to. 

DUNHAM. 

[  COPY.  ] 

PHILADELPHIA,  August  i8th,  1853. 
Dr.  WM.  GARDINER, 

Sir:  You  say,  in  your  Journal,  the  last  number,  page  318,  you  "  wish  to  deal 
justly "—"  nothing  further  to  be  published  on  that  subject."  On  the  same 

6 


66  APPENDIX. 

page  you  allow  your  own  name  to  be  put  at  the  head  of  a  committee  to 
examine  the  original  manuscript  of  Dr.  Hering's  preface,  or  as  an  alternative 
the  mean  threat  of  setting  New- York  pettifoggers  upon  the  first  one  who  has 
had  ability  and  courage  to  awake  the  attention  of  American  Homoeopaths  to 
the  danger  to  which  monopolizing  and  book  manufacturing  leads  our  cause.  I 
am  willing  to  lay  in  the  hands  of  any  respectable  committee  meeting  in  Phila- 
delphia, at  any  time, 

1.  My  original  manuscript. 

2.  The  verbatim  printed  copy  in  the  Allg.  Horn,  Zeitung. 

3.  The  English  translation  of  it  as  a  preface  to  the  Symptomen  Codex. 

4.  A  comparison  of  the  translation  with  the  original,  pointing  out  the  willful 
perversions  and  omissions. 

Said  committee,  according  to  common  sense  and  custom,  cannot  have  any 
interested  parties  members  of  it,  but  ought  to  be  appointed  by  them,  and  of 
course  only  of  such  physicians  as  understand  the  German  language.  You 
ought  to  be  the  umpire.  Is  not  your  Journal  the  proper  organ  in  which  such  a 
report  of  such  a  committee  ought  to  be  published  ? 
(Signed) 

Yours, 

CONSTANTINE   HERING. 


ANTAGONISM    BETWEEN    HOMOEOPATHY   AND 
ALLOPATHY. 

Address,  delivered  at  the  semi-annual  meeting  of  the  Homoeopathic  Medical 
Society  of  the  State  of  New- York,  Albany,  February  10,  1863. 

Gentlemen  of  the  Society  : 

By  the  request  of  your  president  and  other  officers,  I 
appear  before  you  to  perform  that  duty  which,  on  such  an 
occasion  as  this,  devolves  upon  the  president  of  the  Society, 
but  which  the  special  engagements  of  that  officer,  at  this 
season  of  the  year,  in  New- York,  have  prevented  his  ful- 
filling. 

The  session  of  this  evening  brings  to  a  close  the  first 
regular  meeting  of  the  Homoeopathic  Medical  Society  of  the 
State  of  New- York. 

The  object  of  this  Society  is  declared  to  be  "  the  advance- 
ment of  the  science  of  medicine." 

In  these  days,  when  the  value  of  associated  labor  is  so 
well  understood,  one  might  certainly  ask,  with  surprise, 
"  Can  it  be  that,  prior  to  this  year,  there  has  existed  in  the 
State  of  New- York  no  central  organization  for  the  advance- 
ment of  the  science  of  medicine  ?  " 

The  fact  is,  there  has  been  a  State  Medical  Society  in 
active  operation  since  1806.  Its  object  is  the  same  as  that 
of  our  Society ;  its  organization  and  its  mode  of  operation 
are  identical  with  ours. 

What,  then,  is  the  necessity  for  a  second  Society  ?  Why 
should  men  of  the  same  profession,  engaged  in  similar 
labors,  for  a  common  object,  divide  their  forces,  and  thereby 
diminish  their  efficiency?  What  is  the  nature  of  the 
antagonism  which  this  division  implies,  and  what  is  the 


68  ANTAGONISM   BETWEEN 

necessity  for  its  perpetuation  ?  Candid  and  exhaustive 
replies  to  these  questions  will  explain  and  justify  our  posi- 
tion of  separation  from  the  Old  School  of  medicine.  They 
will,  at  the  same  time,  sharply  define  the  outlines  of  that 
branch  of  medical  science  to  which  we  have  especially 
devoted  ourselves,  and  will  give  us  a  clear  view  of  the  labors 
which  devolve  upon  us  for  its  advancement  and  develop- 
ment. 

I  propose,  therefore,  to  discuss  this  antagonism, — first 
from  a  historic  and  then  from  a  philosophical  point  of  view. 

Samuel  Hahnemann,  the  great  reformer  of  medicine,  was 
a  regularly  educated  physician,  of  great  learning  and  very 
uncommon  general  culture  and  literary  attainments.  In  the 
words  of  Sir  John  Forbes,  who  surely  cannot  be  accused  of 
any  partiality  for  the  founder  of  Homoeopathy  :  "  No  candid 
observer  of  his  actions,  or  candid  reader  of  his  writings,  can 
hesitate  for  a  moment  to  admit  that  he  was  a  very  extraor- 
dinary man, — one  whose  name  will  descend  to  posterity  as 
the  exclusive  excogitator  and  founder  of  an  original  system 
of  medicine,  as  ingenious  as  many  that  preceded  it,  and 
destined,  probably,  to  be  the  remote,  if  not  the  immediate, 
cause  of  more  important  fundamental  changes  in  the  prac- 
tice of  the  healing  art  than  have  resulted  from  any  promul- 
gated since  the  days  of  Galen  himself;  *  *  * 
he  was  undoubtedly  a  man  of  genius,  and  a  scholar  ;  a 
man  of  indefatigable  industry  and  of  dauntless  energy."1 

Hufeland,  the  Nestor  of  orthodox  medicine  in  Germany, 
in  calling  attention  to  an  essay  published  by  Hahnemann,  in 
his  Journal,  in  1801,  speaks  of  him  as  "one  of  the  most  dis- 
tinguished physicians  in  Germany." 

This  being  the  estimate  in  which  Hahnemann  was  held  by 
his  most  distinguished  contemporary  (Hufeland)  and  by  his 
most  learned  critic  (Forbes),  both  of  whom,  be  it  observed, 
were  opposed  to  the  medical  reform  which  he  had  instituted, 
let  us  glance  at  his  professional  career. 

1  British  and  Foreign  Medical  Review,  xli.,  1846. 


HOMOEOPATHY   AND   ALLOPATHY.  69 

After  practicing  in  various  localities  and  positions,  with 
such  success  and  acceptance  as  to  acquire  the  reputation 
which  Hufeland  records  of  being  "  one  of  the  most  distin- 
guished physicians  in  Germany,"  Hahnemann  tells  the  pro- 
fession, in  several  essays  on  medical  subjects,  that  he  has 
become  so  deeply  convinced  of  the  uncertainty  of  medical 
practice,  and  of  the  positive  injurious  effects  of  many  meth- 
ods in  common  use  among  physicians  at  that  day,  that  at 
length  he  really  "doubts  whether  his  patients  would  not,  in 
many  cases,  have  thriven  as  well,  or  better,  without  his  aid  as 
with  it." 

This  conviction  of  the  uncertainty  of  medicine,  this  sus- 
picion of  the  injury  which  it  sometimes  inflicts  on  the 
patients,  were  not  peculiar  to  Hahnemann.  Girtanner  and 
several  others,  before  his  day,  expressed  them.  Sir  John 
Forbes,  from  whom  we  have  already  quoted,  says,  in  1846, 
of  the  medical  methods  of  our  own  time,  "  In  a  considerable 
proportion  of  diseases  it  would  fare  as  well,  or  better,  with 
patients,  in  the  actual  condition  of  the  medical  art,  as  more 
generally  practiced,  if  all  remedies,  at  least  all  active  reme- 
dies, especially  drugs,  were  abandoned."  "Things  [in  medi- 
cine] have  arrived  at  such  a  pitch,  that  they  cannot  be  worse; 
they  must  mend  or  end."1  Such  views  have  been  repeatedly 
expressed  by  members  of  the  medical  profession  in  this 
country. 

Hahnemann  has  said  nothing  more  severe  nor  more 
sweeping  than  this  condemnation  of  practical  medicine, 
by  the  late  head  of  the  profession  in  England. 

But  what  did  Hahnemann  do  when  he  had  become  con- 
vinced of  the  inutility  and  mischievousness  of  the  current 
medical  methods  ?  Did  he  continue  a  routine  practice  for 
the  sake  of  "making  a  living?"  No!  like  a  noble,  honest 
man,  he  refused  to  make  a  pretense  of  curing  where  he 
believed  he  did  not  cure.  He  relinquished  the  practice  of 
medicine  and  devoted  himself  to  the  collateral  science  of 

1  British  and  Foreign  Medical  Review,  xli.,  1846. 


70  ANTAGONISM   BETWEEN 

chemistry  and  to  literary  labors.  But  his  mind  was  ever  at 
work  on  the  great  question  of  the  improvement  of  the  prac- 
tice of  medicine,  for  he  was  "  sure  that  the  Creator  had  not 
left  His  creatures  without  a  means  of  succor  from  the  pangs 
and  ravages  of  disease." 

Thus  intent  on  this  subject,  he  could  not  fail  to  remark 
that  although  the  prevailing  treatment  of  diseases  was,  in 
general,  blind  and  at  least  ineffectual  to  cure,  yet  there  were 
certain  remedies  which  were  used  in  the  case  of  certain  dis- 
eases with  almost  uniformly  happy  results — or  at  least  with 
such  results  as  left  no  room  for  doubting  that  in  these  cases, 
at  least,  real  cures  were  effected.  This  he  had  observed  to 
be  the  result  of  the  use  of  mercury  in  certain  cases,  not 
unfrequently  encountered  by  medical  men  ;  but  his  attention 
was  especially  called  to  the  fact  in  connection  with  Peruvian 
bark,  the  febrifuge  properties  of  which  had,  during  the  latter 
part  of  the  preceding  century,  become  well  established  and 
highly  prized  on  the  continent. 

"  If,"  he  thought  to  himself,  "  if  the  number  of  these 
specific  remedies  could  be  vastly  increased,  and  if  some  sys- 
tem could  be  discovered  in  accordance  with  which  we  could 
ascertain  their  exact  properties  and  could  know  beforehand 
in  what  cases  of  disease  they  would  be  applicable,  then  in- 
deed would  the  uncertainties  of  medical  practice  be  removed, 
then  might  we  anticipate  as  great  success  in  the  treatment 
of  all  diseases  as  we  now  attain  in  the  treatment  of  a  few  for 
which  we  have  specifics." 

This  desire  for  specifics  was  not  original  with  Hahnemann. 
It  had  been  expressed  before  his  day  by  Bacon  and  by  Boyle. 
Sydenham  had  longed  for  them  in  expressions  almost 
pathetic  in  their  hopelessness.  But  Hahnemann,  with  his 
"dauntless  energy  and  indefatigable  industry,"  went  to  work 
to  discover  this  system. 

A  casual  observation  in  Cullen's  Materia  Medica  gave  him 
the  clue  to  his  discovery,  as  the  falling  apple  did  to  Newton, 
and  the  swinging  chandelier  in  the  church  at  Pisa,  to  Galileo. 


HOMOEOPATHY   AND   ALLOPATHY.  71 

From  this  observation  it  occurred  to  him  that  provings  of 
drugs  upon  healthy  persons  might  furnish  a  knowledge  of 
their  specific  properties,  and  that  the  administration  of  drugs 
in  cases  presenting  symptoms  similar  to  those  which  the  drug 
produces  in  the  healthy  subject,  might  be  the  law  of  the  ap- 
plication of  specifics. 

He  sought  throughout  the  whole  medical  literature  of 
ancient  and  modern  times  for  instances  bearing  upon  this 
subject,  and  he  collected  a  large  mass  of  evidence  corrobo- 
rating his  speculations. 

He  then  proceeded  to  verHy  his  theory  by  actual  experi- 
ment. First  upon  himself  and  then  upon  all  healthy 
persons  who  would  join  him  in  these  self-sacrificing  labors, 
he  proved  the  effects  of  a  number  of  drugs.  Then,  cautiously, 
first  in  his  own  family,  and  then,  little  by  little,  in  his 
general  practice,  which  he  had  now  resumed,  he  gave,  as 
occasion  offered,  the  drugs  which  he  had  proved,  in  cases 
of  disease  that  presented  symptoms  similar  to  those  pro- 
duced by  the  drugs. 

From  1790  to  1805,  fifteen  years  of  the  prime  of  his  life 
were  devoted  to  constant,  exhausting  labors  of  this  nature, 
during  which  time  he  proved  on  his  own  person  more  than 
sixty  drugs  ;  "  for,"  said  he,  "  when  we  have  to  do  with  an 
art  whose  end  is  the  saving  of  human  life,  any  neglect  to 
make  ourselves  masters  of  it  becomes  a  crime  !  "  At  the 
end  of  this  period,  sure  of  the  truth  of  the  great  principle  he 
had  discovered, — with  all  the  incidental  testimony  of  history 
to  support  it — with  the  positive  results  of  a  long  experience 
to  confirm  it, — he  presented  his  views  and  the  results  of  his 
labors  to  the  profession  in  an  essay  of  wonderful  logical 
power,  of  the  utmost  moderation  in  expression,  full  of  almost 
tender  persuasion  and  of  the  noblest  enthusiasm;2  and  he 
published  at  the  same  time  the  first  part  of  his  Materia 
Medica.3  Five  years  later  appeared  the  more  elaborate 
exposition,  the  "  Organon." 

1  Dudgeon,   Hahnemann's    Lesser          2  Medicine  of  Experience. 
Writings.  3  Frag,  de  Vir.  Med.  pos. 


72  ANTAGONISM    BETWEEN 

This  was  the  turning-point  of  Hahnemann's  career.  Let 
us  see  what  was  his  relation  to  the  profession  at  this  time. 

He  had,  by  universal  consent,  attained  a  position  in  the 
profession  which  justified  him  in  assuming  to  criticise  pre- 
vailing methods  and  to  suggest  improvements.  He  had 
shown  the  need  of  improvements,  and  he  had  borne  testi- 
mony to  his  honesty  in  this  exposition,  by  retiring  from  a 
lucrative  practice.  He  now  came  before  the  profession  say- 
ing, "  I  believe  I  have  discovered  a  system  which  will  render 
the  practice  of  medicine  certain,  and  its  success  brilliant.  I 
have  labored  fifteen  years  to  test  my  discovery.  My  own 
experiments  and  the  testimony  furnished  by  the  records  of 
medicine  convince  me  of  its  truth.  I  lay  it  and  them  before 
you,  my  colleagues,  and  I  conjure  you  in  the  name  of  truth, 
by  the  interests  of  humanity,  to  investigate  it  candidly  and 
without  prejudice."  "  If,"  he  says  in  his  letter  to  Hufeland 
on  this  occasion,  "  if  experience  should  show  you  that  my 
method  is  the  best,  then  make  use  of  it  for  the  benefit  of 
mankind,  and  give  God  the  glory !" 

How  were  this  exposition  and  appeal  received  by  the 
medical  men  of  the  day  ? 

In  1811,  appeared  the  Anti-Organon  of  Prof.  Hecker — a 
work  full  of  the  most  bitter  aspersions  upon  Hahnemann's 
personal  character,  whereas,  in  fact,  the  question  had  rela- 
tion to  principles  and  not  to  persons  ;  abounding  in  the  most 
concentrated  contempt  and  scorn  of  the  system  which  Hahne- 
mann  had  unfolded  ;  and  without  a  single  suggestion  to 
investigate,  by  practical  experiment,  the  practical  method 

which  Hahnemann  had  stated  to  have  been  attended,  in  his 

• 

hands,  with  such  brilliant  practical  success  ! 

And  from  that  day  to  the  present,  all  the  utterances  of 
the  Old  School,  whether  from  the  press,  the  council,  the 
professor's  chair,  or  in  the  forum  of  the  academy,  have  been 
bitter  personal  denunciations  and  aspersions  of  the  character 
and  motives  of  Hahnemann,  and  of  all  who  have  adopted  or 
have  even  shown  a  disposition  to  investigate  his  method. 


HOMCEOPATHY   AND   ALLOPATHY.  73 

But  many  a  scientific  discoverer  has  met  with  opposition 
and  calumny  at  the  hands  of  his  colleagues.  Not  to  go 
beyond  the  ranks  of  medicine,  Harvey  was  denounced  as  a 
quack,  because  he  demonstrated  the  circulation  of  the  blood  ! 
Jenner  was  scandalized  with  most  persistent  violence  because 
he  introduced  vaccination. 

To  Hahnemann,  however,  persecution  came  nearer  home. 
After  he  had  satisfied  himself  of  the  value  of  his  discovery 
of  the  true  method  of  medical  practice,  he  resumed  the 
exercise  of  his  profession.  His  success  was  more  brilliant 
than  it  had  ever  been.  His  fame  as  a  practitioner  grew 
rapidly,  and  patients  began  to  come  to  him  from  consider- 
able distances.  This  good  fortune  excited  the  envy  of  his 
colleagues  in  Konigslutter,  where  he  then  resided.  At  their 
instigation,  the  apothecaries  of  the  place  brought  a  prosecu- 
tion against  him  for  infringement  of  the  law  which  forbids  to 
practitioners  of  medicine  the  compounding  and  sale  of  the 
remedies  they  prescribe.  For,  it  must  be  observed,  that,  as 
an  inevitable  corollary  to  his  new  sys'tem  of  practice,  Hahne- 
mann had  come  to  prescribe  only  a  single  drug  at  a  time, 
and  that  he  used  simple  preparations  such  as  could  not  be 
obtained  in  the  requisite  purity  at  the  apothecaries'.  In 
vain  it  was  urged  that  the  spirit  of  the  law  was  not  infringed, 
since  Hahnemann  himself  was  an  expert  apothecary  and 
chemist,  and  since  his  remedies  were  not  "  compounded,"  but 
simples,  and  not  "sold,"  but  dispensed  gratuitously.  The 
opposition  was  too  strong.  He  was  forbidden  to  practice, 
save  in  accordance  with  the  law  alluded  to. 

Rather  than  yield  in  a  matter  which  he  considered  essen- 
tial to  the  freedom  of  the  physician  and  to  the  purity  and 
certainty  of  his  practice,  Hahnemann  determined  to  leave 
Konigslutter;  and  accordingly,  to  the  delight  of  his  col- 
leagues and  of  the  apothecaries,  and  to  the  regret  of  the 
citizens,  who  were  loath  to  lose  their  benefactor,  and  a  cortege 
of  whom  attended  his  carriage  far  beyond  the  gates  of  the 
town,  he  removed  to  Hamburg. 


74  ANTAGONISM    BETWEEN 

Here,  as  he  became  known  and  appreciated,  the  same 
persecution  was  revived,  and  with  the  same  result.  He 
removed  to  Altona. 

In  this  way,  during  a  period  of  twenty-two  years,  from 
1799  to  1821,  Hahnemann  was  constrained,  by  the  persecu- 
tion of  his  colleagues,  under  cover  of  the  law,  to  change 
his  abode  at  least  eleven  times.  The  last  place  from  which 
he  was  driven  in  this  manner  was  Leipsic — a  city  for  which 
he  had  a  peculiar  affection.  Here  he  had  pursued  his 
earliest  medical  studies  and  met  with  his  first  successes. 
Here  he  had,  in  later  years,  established  a  college  of 
Homoeopathy,  and  had  lectured  to  large  audiences.  In 
the  shady  walks  and  groves  that  surround  the  city,  he 
had  been  wont  to  spend  the  evening  of  each  day  in  social 
converse  with  his  family  and  with  the  students  whom  he 
had  gathered  about  him  and  who  took  part  in  his  labors  of 
proving  drugs. 

From  this  city  of  his  love,  the  scientific  capital  of  his 
fatherland,  he  was  now,  in  the  sixty-sixth  year  of  his 
laborious  life,  driven  away  to  an  asylum  offered  him  in 
the  tiny  capital  of  the  tiny  Duchy  of  Anhalt-Coethen  ! 

No  wonder  that  he  who  for  so  many  years  had  followed 
the  injunction,  "  When  they  persecute  you  in  one  city, 
flee  ye  to  another," — that  he  who,  like  the  Divine  Healer, 
had  gone  "  about  from  place  to  place  doing  good  and 
healing  all  manner  of  sickness  and  disease  among  the 
people" — no  wonder  that  he  forgot,  under  the  pressure 
of  this  last  indignity,  that  other  injunction  of  the  Divine 
Teacher,  to  "  love  them  that  hate  you,  and  pray  for  them 
that  despitefully  use  you  and  persecute  you,"  and  that,  like 
Luther,  he  now  bared  his  hitherto  sheathed  weapons  of 
satire  and  invective  against  those  who  had  striven  to  hinder 
his  usefulness  —  who  had  so  cruelly  marred  his  peace  and 
happiness — all  save  that  peace  which  can  never  be  taken 
from  the  man  who  has  within  himself  the  "  mens  sibi  conscia 
recti ! "  If  in  this  he  erred  and  came  short  of  the  Divine 


HOMCEOPATHY  AND   ALLOPATHY.  75 

example,  let  him  among  men  who  is  "  pure,"  cast  the  first 
stone  at  him  ! 

Time  brings  its  sweet  revenges.  After  a  career  of  honor 
and  usefulness  at  Coethen,  where  his  ever-increasing  fame 
brought  him  throngs  of  patients  from  all  parts  of  Europe, 
and  a  subsequent  residence  in  Paris,  where  his  reputation 
extorted  from  the  government  a  license  to  practice  as  he 
pleased,  Hahnemann  died  at  Paris  in  1843,  full  of  years 
and  honors.  Eight  years  afterward,  in  1851,  the  town 
council  of  Leipsic  appropriated  a  beautiful  plot  of  ground 
as  a  site  for  his  monument,  and  the  council  celebrated 
officially  the  uncovering  of  a  costly  and  beautiful  bronze 
statue  of  that  man,  as  one  of  Saxony's  most  illustrious 
sons,  whom  thirty  years  before  the  same  council  had  igno- 
miniously  chased  from  their  borders  as  an  unauthorized 
and  illegal  prescriber ! 

Before  we  leave  this  branch  of  our  subject,  let  us  draw 
one  lesson  from  the  story  of  Hahnemann's  persecutions. 
All  his  sufferings  might  have  been  avoided,  he  might  have 
lived  in  peace  and  affluence,  enjoying  consideration  among 
his  colleagues  and  making  plenty  of  money,  had  he  been 
willing  to  "yield  a  little,"  to  waive  the  right  of  dispensing 
his  own  medicines,  to  accommodate  his  system  in  various 
points  to  suit  the  notions  of  his  time.  The  temptation  to 
do  this  might,  by  some,  be  supposed  to  have  been  great, 
for  Hahnemann's  family  was  large,  he  suffered  during  his 
wanderings  from  the  pinchings  of  cruel  poverty,  and  this 
took  from  him  the  leisure  so  necessary  for  his  studies. 

But  Hahnemann  was  not  made  of  the  stuff  that  could 
compromise,  for  personal  ease  and  prosperity,  the  charter 
that  God  had  given  him  for  the  benefit  of  the  race.  He 
refused  to  give  up  one  particle  of  anything  which  he 
deemed  essential  to  the  purity  and  perfectness  of  his  system, 
and  so  he  has  left  it  to  us,  pure  and  perfect ! 

Let  us  remember  his  example  when  prospects  of  ease  and 
consideration,  and  of  the  cessation  of  strife  for  the  truth, 


76  ANTAGONISM   BETWEEN 

tempt  us  to  compromise   unworthily  with  any  portion  of 
the  Old  School  of  medicine. 

For  there  are  those  among  us,  as  there  are  men  in  other 
walks  of  life,  who,  for  the  sake  of  what  they  call  peace 
and  union,  would  join  hands  with  what  they  know  to  be 
false  !  aye,  even  though  to  do  it,  they  should  have  to  "  cut 
off  the  fanatics,"  who  adhere  strictly  to  Hahnemann, —  to 
leave  the  "  brains"  of  their  system  "  out  in  the  cold." 

This  is  the  origin  and  the  personal  history  of  the  antag- 
onism between  Homoeopathy  and  the  dominant  school  of 
medicine.  Hahnemann  showed  the  imperfections  of  the 
current  methods.  Nobody  disproved  what  he  said.  Every- 
body agreed  with  him  and  everybody  sighed  for  something 
better.  He  discovered  something  better  and  offered  it  to 
his  colleagues,  with  demonstrations  of  its  value  ;  he  begged 
them  to  investigate  it;  and  in  case  they  should  find  it 
better  than  the  old  method,  to  use  it  for  the  good  of  man- 
kind, and  give  God  the  glory  !  Then,  with  one  accord, 
they  denounced  him  as  a  vile  impostor,  and  chased  him 
from  their  midst,  nor  have  they  yet  ceased  to  heap  ignominy 
on  his  name  ! 

It  may  be  objected  that  I  have  not  stated  the  whole 
grounds  of  the  opposition  of  the  Old  School  to  Homoeop- 
athy, inasmuch  as  I  have  said  nothing  about  the  "  little 
doses." 

If  this  were  true,  it  would  not  alter  the  bearings  of  the 
case,  because  the  doctrine  of  the  "  little  doses,"  like  all  the 
rest  of  Hahnemann's  method,  was  offered  to  the  profession, 
to  be  by  them  submitted  to  the  test  of  experience,  by  which, 
like  all  the  rest,  it  should  stand  or  fall.  But,  in  point  of 
fact,  Hahnemann  came  very  slowly  to  see  the  necessity  of 
giving  small  doses  when  he  prescribed  according  to  the  law 
of  Homoeopathy ;  and  he  did  not  express  himself  authorita- 
tively upon  this  subject  until  long  after  the  opposition  to 
him  and  the  prosecutions  in  the  name  of  the  apothecaries 


HOMCEOPATHY   AND   ALLOPATHY.  77 

were  in  full  blast !  Therefore,  this  opposition  could  not 
have  originated  in  the  doctrine  of  the  dose. 

Nor  is  the  question  of  the  dose  at  all  essential  to  the 
experiments  which  Hahnemann  invited  his  professional 
brethren  to  make  for  the  purpose  of  testing  his  system. 
Intelligent  experiments  with  doses  of  ordinary  size  would 
convince  any  physician  of  the  truth  of  the  Homoeopathic 
law;  and  if  he  continued  the  experiments,  the  inconven- 
iences that  he  would  find  to  result  from  the  use  of  such 
doses  would  inevitably  lead  the  experimenter,  as  they  led 
Hahnemann,  to  continually  diminish  the  dose,  until  he 
should  become  convinced  of  the  truth  of  Hahnemann's 
dogma  on  this  subject  also. 

This  has  been  the  uniform  experience  of  all  physicians 
who  have  become  convinced,  through  experiment,  of  the 
truth  of  Homoeopathy,  and  have  adopted  the  method  in 
practice.  And  the  more  strictly  they  conform  to  Hahne- 
mann's method  in  prescribing,  the  more  exactly  do  they 
agree  with  him  respecting  the  dose.  The  number  of  these 
witnesses  amounts  to-day  to  many  thousands,  and  their 
concurrent  testimony  does  not  admit  of  dispute. 

Let  us  now  consider  this  antagonism  from  a  philosophical 
point  of  view. 

As  I  have  already  said,  Hahnemann  perceived  that  the 
prevailing  method  of  treating  disease  comprised  two 
processes. 

One  of  these  processes  was  what  was  then,  and  is  still, 
called  the  "Rational."  It  involves  a  theory  of  the  cause 
and  essential  nature  of  the  disease,  and  the  resort  to  some 
expedient  which  would  be  likely  to  remove  this  supposed 
cause  of  the  disease,  and  to  bring  about  a  contrary  state, 
and  so  conduce  to  health.  Of  this  kind  was  Galen's 
method,  which  divided  diseases  into  hot,  cold,  moist  and 
dry;  made  a  similar  classification  of  remedies,  and  applied 
to  each  disease  a  remedy  from  a  class  of  the  contrary 


78  ANTAGONISM   BETWEEN 

nature.  Less  glaringly  absurd,  but  in  no  way  different  in 
nature,  are  the  theories  which  hold  that  certain  diseases, 
for  example,  are  caused  by  accumulation  of  the  blood  in 
certain  organs,  and  are  to  be  cured  by  abstraction  of  blood ; 
that  others  depend  upon  what  is  imagined  to  be  want  of 
tone,  and  are  to  be  cured  by  remedies  which  are  assumed 
to  be  tonics ;  that  others  are  due  to  a  languid  state  of  the 
"  animal  spirits,"  and  are  to  be  encountered  by  the  admin- 
istration of  "stimulants"  etc. 

That  these  were  the  grounds  upon  which  the  prevalent 
methods,  in  the  generation  preceding  Hahnemann,  were 
based,  is  shown  by  Cullen's  theory  of  the  action  of  bark, 
and  also  by  the  following  passage  from  "  Sydenham  on 
Pleurisy :  " 

"  After  attentively  considering  the  various  phenomena  of 
this  disease,  I  think  it  is  a  fever  originating  in  a  proper  and 
peculiar  inflammation  of  the  blood, — an  inflammation  by 
means  of  which  nature  deposits  the  peccant  matter  in  the 
pleurae.  In  my  treatment,  I  have  the  following  aim  in 
view :  to  repress  the  inflammation  of  the  blood,  and  to 
divert  those  inflamed  particles  which  have  made  an  onset 
on  the  lining  membrane  of  the  ribs  (and  which  have  lit 
up  so  much  mischief)  into  their  proper  outlets.  For  this 
reason,  my  sheet-anchor  is  blood-letting" 

A  modification  of  this  process  is  that  which  is  known  as 
the  Hippocratic  method  of  observing  and  following  the 
indications  of  nature;  in  the  words  of  Sydenham,  "watch- 
ing what  method  Nature  might  take,  with  the  intention  of 
subduing  symptoms  by  following  in  her  footsteps."  Accord- 
ing to  this  method,  if,  in  any  disease,  recovery  was  preceded 
by  a  critical  evacuation, —  such  as  a  copious  sweat, —  this 
was  assumed  to  be  nature's  method,  and  sudorifics  were 
accordingly  resorted  to  in  similar  cases. 

Now,  independently  of  the  fatal  objection,  that  this 
method  would  confine  our  curative  power  to  such  diseases 
as  Nature  herself  \s  wont  to  cure  by  critical  discharges,  etc., — 


HOMCEOPATHY   AND   ALLOPATHY.  79 

the  very  diseases,  therefore,  in  which  medical  aid  could  be 
best  dispensed  with, —  while  it  makes  no  provision  at  all  for 
such  diseases  as  rarely  or  never  get  well  of  themselves, — 
such  as  nature  never  cures  by  critical  discharges, — the 
very  cases,  therefore,  in  which  there  is  most  need  of  the 
intervention  of  art, — Sydenham  tells  us  that  he  "found  that 
spontaneous  sweats  often  did  good."  "  But  these,"  he  says, 
"were  very  different  things  irom  forced  ones."  And  Hahne- 
mann  showed  that  "  in  such  cases  the  critical  discharges 
and  the  recovery  were  simultaneous;  that  the  discharge  was 
the  consequence  and  announcement  rather  than  the  cause  of 
the  recovery ;  and  that  to  infer  from  such  a  state  of  things 
that  we  could  bring  about  a  cure  by  inducing  an  artificial 
sweat,  would  be  like  ringing  bells  and  lighting  bonfires  to 
secure  a  victory  instead  of  to  announce  one."1 

The  other  process,  which  Hahnemann  perceived  to  be 
comprised  in  the  prevailing  methods  of  treatment,  was — 
administering,  in  the  case  of  a  very  few  diseases,  of  which 
fever  from  marsh  miasma  may  be  taken  as  the  most  illustri- 
ous example,  certain  remedies  which  had  been  discovered  to 
possess,  in  some  unexplained  way,  a  power  to  cure  these  dis- 
eases. Such  remedies  had  been  discovered  by  the  merest 
accident.  No  method  was  known  by  which  others  could  be 
discovered:  no  method  had  been  suggested  by  which  it 
could  be  more  clearly  ascertained  and  defined  for  what  par- 
ticular varieties  of  the  diseases  in  question  these  "  specifics," 
as  they  were  called,  were  especially  appropriate. 

Hahnemann  showed  the  fallacy  of  the  philosophy  on 
which  the  "  Rational"  method  was  based.  He  showed  that, 
even  admitting  that  accumulations  of  blood  do  exist  as  the 
"  proximate  cause"  in  certain  diseased  conditions,  yet  these 
accumulations  cannot  be  regarded  as  the  essential  cause  of 
the  disease.  On  the  contrary,  that  cause  must  be  sought  in 
that  force  which  regulates  the  circulation  and  preserves  its 
equilibrium.  This  force  must  have  been  set  into  abnormal 
i  Russell,  History  and  Heroes  of  the  Art  of  Medicine.— "  Sydenham." 


8O  ANTAGONISM   BETWEEN 

action,  in  order  that  an  accumulation  could  take  place  in  any 
particular  organs;  and,  therefore,  in  the  accumulations  we  see, 
not  the  essential  cause  of  the  disease,  but  only  one  of  the  results 
of  that  cause.  To  undertake,  then,  by  abstraction  of  blood  to 
remove  a  result  of  the  cause,  is  not  to  cure  the  disease  by 
removing  the  cause,  but  only  to  seek  to  palliate  it  by  carry- 
ing away  some  of  its  products.  He  showed,  further,  that  this 
abnormal  condition  of  one  of  the  dynamic  forces,  the  action 
of  which  constitutes  the  life  of  the  body,  is  beyond  the 
sphere  of  our  observation.  Like  the  healthy  action  of  these 
same  forces — in  a  word,  like  life  —  it  is  an  ultimate  fact, 
behind  which  we  cannot  penetrate,  and  which,  therefore,  we 
cannot  study  as  a  cause  of  disease  and  seek  to  remove  by 
direct  rational  means. 

But  Hahnemann  went  farther,  and  showed  that,  although 
we  cannot  investigate  the  ultimate  nature  and  causes  of  those 
modifications  of  the  dynamic  forces  of  the  organism,  which 
are  the  essential  causes  of  diseased  action,  and  then  remove 
them,  as  a  "  rational"  method  would  propose  to  do,  yet  that 
if,  while  a  disease  is  in  full  vigor,  we  administer  a  remedy 
which  causes  a  sudden  cessation  of  the  morbid  action  with- 
out any  abstraction  of  the  fluids  or  any  derivative  action 
whatever,  we  are  then  justified  in  concluding  that  the  remedy 
we  have  given  has,  in  some  way  or  other  peculiar  to  itself 
reached  that  force  which  was  in  a  state  of  abnormal  action, 
and  has  so  modified  it  as  to  bring  it  back  to  a  condition  of 
normal  action  ;  that  this  remedy  has  a  "  specific  "  effect  upon 
that  force  under  certain  conditions ;  and  we  draw  this  con- 
clusion upon  the  general  principle  that  when  an  effect  ceases 
we  may  conclude  that  the  cause  has  ceased  to  act. 

And  Hahnemann  showed,  farther,  that  if  we  could  discover 
substances  having  such  a  specific  action,  and  a  law  by  which 
we  should  know  just  when  to  apply  them,  we  should  have 
accomplished  the  much  needed  reform  in  medical  science. 

He  appreciated  so  highly  the  value  of  the  specifics  of  which 
medicine  was  already  in  possession,  that  he  consecrated  his 


HOMCEOPATHY  AND   ALLOPATHY.  8 1 

life  to  the  task  of  discovering  a  method  of  increasing  their 
number  and  of  reducing  their  use  to  a  system. 

In  this  appreciation  of  the  direction  in  which  alone  im- 
provement in  the  curing  of  diseases  was  to  be  looked  for, 
Hahnemann  was  anticipated,  as  I  have  said,  by  Bacon,  Boyle 
and  Sydenham. 

Thus  Bacon,  in  the  "  Advancement  of  Learning,"  after  a 
sweeping  condemnation  of  the  unphilosophical  method  of 
Galen,  says  :  "  A  work  is  wanting  upon  the  cures  of  reput- 
edly incurable  diseases,  that  physicians  of  eminence  and  res- 
olution may  be  excited  and  encouraged  to  pursue  the  matter 
as  far  as  the  nature  of  things  will  permit ;  since  to  pronounce 
diseases  to  be  incurable  is  to  exhibit  ignorance  and  careless- 
ness, as  it  were,  and  to  screen  ignorance  from  reproach." 
And  again,  "  I  find  a  deficiency  in  the  receipts  of  propriety 
respecting  the  cure  of  particular  diseases."  Again,  "  They 
have  no  particular  medicines  which,  by  a  specific  property, 
are  adapted  to  particular  diseases.  I  remember  a  learned 
Jew  physician  who  used  to  say,  '  Your  European  physi- 
cians are  like  bishops;  they  have  the  keys  of  binding 
and  loosing — nothing  more  !'  It  would  be  of  great  conse- 
quence if  physicians  eminent  for  learning  and  practical  skill 
would  compile  a  work  of  approved  and  experienced  medi- 
cines in  particular  diseases." 

The  learned  Boyle,  the  father  of  chemistry,  who  had 
devoted  much  time  to  the  study  of  medicine,  says  :  "  I  can- 
not forbear  to  wish  that  divers  learned  physicians  were  more 
concerned  than  they  seem  to  be  to  advance  the  curative  part 
of  their  profession,  without  which,  three  at  least,  of  four 
other  parts,  may  prove  indeed  delightful  and  beneficial  to  the 
physician,  but  will  be  of  very  little  use  to  the  patient,  whose 
relief  is  yet  the  principal  end  of  physic.  I  had  much  rather 
that  the  physician  of  any  friend  of  mine  should  keep  his 
patient,  by  powerful  medicines,  from  dying,  than  tell  me 
punctually  when  he  shall  die,  or  show  me  in  the  opened  car- 
cass why,  it  is  supposed,  he  lived  no  longer. 
7 


82  ANTAGONISM   BETWEEN 

Again  he  says,  when  speaking  of  the  need  of  specifics  r 
"  Finding  at  every  turn  that  the  main  thing  which  does  pre- 
vail with  learned  physicians  to  reject  specifics  is,  that  they 
cannot  conceive  the  distinct  manner  of  the  specifics'  working, 
and  think  it  utterly  improbable  that  such  a  medicine,  which 
must  pass  through  digestions  in  the  body  and  be  whirled 
about  by  the  mass  of  the  blood  to  all  the  parts,  should, 
respecting  the  rest,  show  itself  friendly  to  the  brain,  for 
instance,  or  the  kidneys,  or  fall  upon  this  or  that  juice  or 
humor  rather  than  any  other. 

"  First,  I  would  demand  of  these  objectors  a  clear  and 
satisfactory,  or  at  least  an  intelligible  explication,  of  the  man- 
ner of  working  of  divers  other  medicaments  that  do  not  pass 
for  specifics.  For  I  confess  that  to  me,  even  many  of  the  vulgar 
operations  of  common  drugs  seem  not  to  have  been  hitherto 
intelligibly  explained  by  physicians,  who  have  yet,  for  aught 
I  have  observed,  to  seek  for  an  account  of  the  manner  of  how 
diuretics,  sudorifics,  etc.,  perform  their  operations,  etc. 

"  The  same  objection  that  is  urged  to  prove  that  a  specific 
cannot  befriend  the  kidneys,  for  example,  or  the  throat  rather 
than  any  other  parts  of  the  body,  lies  against  the  obnoxious- 
ness  of  poisons  to  this  or  that  determinate  part ;  yet  experi- 
ence manifests  that  some  poisons  do  respect  particular  parts 
of  the  body  without  equally  or  at  all  sensibly  offending  the 
rest;  and  we  see  that  cantharides,  in  a  certain  dose,  are 
noxious  to  the  kidneys  and  bladder,  and  quicksilver  to  the 
throat  and  glandules  thereabout,  stramonium  to  the  brain 
and  opium  to  the  animal  spirits  and  genus  nervosum"1 

Sydenham  expresses  himself  on  this  subject  with  his  accus- 
tomed brevity  and  directness.  Speaking  of  intermittent  fever, 
he  says :  "  We  must  do  one  of  two  things ;  we  must,  by 
careful  and  anxious  observation  of  the  process  by  which  nature 
relieves  herself  of  this  disease,  draw  indications  as  to  the  man- 
ner by  which  the  incipient  fermentation  may  be  promoted 

1  Russell,  History  and  Heroes  of  the  Art  of  Medicine,  vol.  ii.,  p.  IOI ; 
art.  "Robert  Boyle." 


HOMCEOPATHY  AND   ALLOPATHY.  83 

and  the  patient  restored  to  health,  or  else  we  must  discover 
a  specific.  By  the  latter  method,  we  shall  attack  the  malady 
directly." 

It  may  be  observed  that  Sydenham  did  not  hesitate  to 
choose  the  latter  method  so  soon  as  the  specific  virtues  of 
Peruvian  bark  in  intermittent  fever  were  recognized,  and  that 
he  was  the  chief  means  of  making  the  value  of  this  great 
specific  known  in  England;  nor  have  the  profession  gener- 
ally, since  his  day,  been  disposed  to  hesitate  in  their  choice 
between  the  Hippocratic  and  the  specific  methods  of  treat- 
ing this  disease, — the  two  alternatives  which  Sydenham  so 
clearly  lays  down. 

He  continues :  "  By  no  means  do  I  wish  to  express  myself 
as  if  wise  and  learned  physicians  were  to  despair ;  as  if  they 
were  to  think  out  no  better  modes  of  treatment,  and  as  if 
they  were  to  throw  away  the  hope  of  discovering  nobler  and 
more  potent  medicines  for  accelerating  the  cure  of  diseases. 
So  far  am  I  from  tjiis  that  I  do  not  despair  of  finding  out, 
even  myself,  some  such  medicines  and  some  such  method  of 
curing." 

These  things  which  Bacon,  Boyle  and  Sydenham  point 
out  so  forcibly  as  the  desiderata  of  Medicine,  which  Syden- 
ham did  not  despair  of  finding  out,  yet  died  without  dis- 
covering,— these  "  specific  medicines,"  and  this  "  methodus 
medendi"  were  offered  to  the  profession  one  hundred  years 
later  by  Hahnemann. 

Dr.  Lettsom  tells  us,  "the  great  Sydenham,  for  all  his 
labors,  only  gained  the  sad  and  unjust  recompense  of  cal- 
umny and  ignominy,  and  that  from  emulation  of  some  of  his 
collegiate  brethren  and  others,  whose  indignation  at  length 
arose  to  that  height  that  they  endeavored  to  banish  him  from 
that  illustrious  society  (the  Royal  College  of  Physicians),  as 
guilty  of  medicinal  heresy." 

And  yet  Sydenham  only  longed  for,  and  looked  forward 
to,  the  discovery  of  specifics  and  of  the  law  of  their  employ- 
ment. He  was  the  Moses  of  the  specific  method.  It  was, 


84  ANTAGONISM  BETWEEN 

therefore,  in  the  regular  course  of  historic  sequence  that 
Hahnemann,  the  Joshua  of  that  method,  who  led  the  hosts 
of  jEsculapius  into  the  promised  land  of  which  the  Moses 
had  had  a  glorious  vision,  should  be  unsparingly  denounced 
as  a  heretic  and  actually  banished  from  every  well-regulated 
society ! 

This,  then,  is  the  antagonism.  Hahnemann  shows  that 
specifics  are  to  be  discovered  by  ascertaining  the  effects  of 
drugs  upon  healthy  persons ;  that  they  are  to  be  applied  by 
giving  to  a  sick  person  such  a  drug  as  would  produce,  in  the 
healthy  subject,  symptoms  similar  to  those  of  the  sick  per- 
son. He  presents  this  discovery  to  the  profession  as  some- 
thing in  advance  of  present  knowledge.  They  refuse  to 
accept  or  even  to  test  it,  and  they  denounce  him  for  offering 
it.  On  which  side  lies  the  onus  of  the  antagonism  ? 

But  it  may  be  said,  however  true  these  statements  are  as 
regards  the  age  for  which  Hahnemann  w/ote,  the  scientific 
progress  of  the  last  fifty  years  has  changed  all  that.  It  has 
changed  the  names  of  things  and  little  besides  in  therapeutics. 
We  hear  no  more,  it  is  true,  of  "temperaments"  and 
"humors,"  of  the  "animal  spirits,"  of  the  "  Arc&Jius"  but 
instead,  the  talk  is  now  of  "  the  dyscrasias,"  of  "  diatheses," 
of  the  "cellular  pathology,"  of  "analogies"  and  "  heterol- 
ogies." 

There  is  the  same  endeavor  to  draw  from  a  theory  of  the 
essential  nature  of  the  disease  a  rational  indication  of  cure, 
of  which  Hahnemann  exposed  the  fallacy  and  impossibility. 
Indeed,  Sir  John  Forbes  affirms,  in  1846,  "The  progress  of 
therapeutics  (the  cure  of  diseases)  during  all  the  centuries 
that  have  elapsed  since  the  days  of  Hippocrates,  has  been 
less  than  that  achieved  by  the  elementary  sciences  of  medi- 
cine during  the  last  fifty  years.  This  department  of  medi- 
cine must  indeed  be  regarded  as  yet  in  its  merest  infancy." 

It  should  be  clearly  understood,  and  I  state  it  most 
emphatically,  that  all  expositions  of  the  insufficiency  and 


HOMCEOPATHY   AND   ALLOPATHY.  8$ 

the  chaotic  state  of  the  prevalent  system  of  medicine — 
whether  by  the  outspoken  leaders  of  the  Old  School,  like 
Forbes,  or  by  Hahnemann  and  his  followers — refer  ex- 
clusively to  the  department  of  therapeutics,  the  science  and 
art  of  curing  diseases  by  medicines.  In  the  development  of 
the  natural  history  of  the  healthy  and  of  the  diseased  body, 
that  is  to  say,  in  the  sciences  of  physiology  and  physio- 
logical anatomy,  and  of  pathology  and  pathological  anatomy, 
as  well  as  in  the  departments  of  hygiene,  surgery,  obstetrics 
and  medical  chemistry,  medicine  has  fully  kept  pace  with 
the  wonderful  progress  of  scientific  knowledge  in  our  day. 
We  profit  by  the  labors  of  our  colleagues  in  these  branches, 
and  accord  them  full  recognition  and  admiration.  But  the 
great  end  and  object  of  all  these  things  is  to  cure  diseases. 
If  they  afford  no  facilities  for  this,  they  are  profitless  to  man- 
kind. Now,  if  the  same  men  who  have  brought  these 
collateral  sciences  to  such  perfection  have  been  unable  to 
bring  therapeutics-  out  of  what  Forbes  calls  its  present  chaos 
of  "  merest  infancy,"  is  not  the  conclusion  irresistible  that 
they  have  not  yet  got  hold  of  the  right  clue — of  the  true 
philosophy  of  the  science  ? 

There  is  even  a  greater  indisposition  in  our  day,  than  in 
the  time  of  Boyle,  to  admit  the  value  and  to  stimulate  the 
discovery  of  specifics.  Nor  is  this  wonderful ;  for  specifics 
obstinately  refuse  to  range  themselves  under  any  rational 
hypothesis.  They  exert  a  peculiar,  inscrutable  action  upon 
certain  organs  when  in  certain  conditions,  and  more  than 
this  nobody  can  say  of  them.  And  yet,  notwithstanding 
their  philosophical  aversion  to  them,  the  practical  sagacity 
of  our  colleagues,  with  which  they  keep  their  philosophy 
strangely  at  variance,  leads  them  to  seize  eagerly  upon 
specifics  whenever  these  are  presented  to  their  notice. 
Witness  the  avidity  with  which  they  have  availed  themselves 
of  Iodine,  Ergot,  Cod  Liver  Oil,  the  Hypophosphites,  Iron, 
Veratrum  viride,  as  well  as  of  Nickel  and  Oxalate  of  Cerium 
which  the  Houdin  of  orthodox  medicine  has  lately  intro- 


86  ANTAGONISM   BETWEEN 

duced  to  them.  Nay,  people  do  say  that  our  learned  friends 
of  the  Old  School  make  frequent  use,  "  upon  the  sly,"  of 
Aconite  as  a  specific  in  fever,  and  of  Nux  vomica  and  of 
Pulsatilla  as  specifics  in  gastrodynia  and  dysmenorrhoea, 
etc.,  etc., — remedies  of  the  specific  properties  of  which  their 
only  knowledge  is  derived  from  the  labors  of  Hahnemann. 

It  is  true,  they  undertake  to  give  a  "rational"  theory  of 
the  action  of  these  specific  remedies,  but  with  as  little  suc- 
cess as  Cullen  met  with  when  he  attempted  to  explain  the 
febrifuge  action  of  Peruvian  bark.  It  is  all  comprised  in 
the  doggerel  explication  that  Moliere  gives  of  the  hypnotic 
effects  of  opium : 

"  Domandatur  causam  et  rationem  quare 
Opium  facit  dormire. 
A  quoi  respondeo, 
Quia  est  in  eo 
Virtus  dormitiva, 
Cujus  est  natura 
Sensus  assoupire." 

Now,  as  in  the  days  of  Hahnemann,  there  is  an  antagonism 
between  the  Homoeopathists  and  the  Old  School.  The 
former  hold  out  to  the  latter  what  they  believe  to  be  that 
method  which  has  ever  been  a  desideratum  in  medicine. 
The  latter  refuse  even  to  examine  it,  and  expel  the  Homoe- 
opathists from  all  associations  over  which  they  hold  control. 
We  cannot  unite  with  them  in  any  associated  labors  without 
ignoring  and  disavowing  what  we  believe  to  be  the  true 
theory  and  practice  of  the  all- important  part  of  medical 
science — the  science  of  therapeutics.  They  will  not  unite 
with  us  in  associated  labors  for  the  development  of  this 
science. 

Had  Hahnemann  done  nothing  more  than  devise  a  method 
of  discovering  and  using  specifics  in  the  gross  and  whole- 
sale sense  in  which  the  term  was  and  is  understood  and  used 
by  the  Old  School  of  medicine,  he  would  still  have  been 
entitled  to  the  gratitude  of  mankind.  He  did  far  more. 


HOMOEOPATHY   AND   ALLOPATHY.  8/ 

He  perceived  that,  in  the  dominant  school,  a  specific  was 
set  apart  as  adapted  to  any  individual  member,  indiscrimi- 
nately, of  a  large  nosological  group  [of  diseases];  that  bark, 
for  example,  was  held  to  be  the  specific  for  malarious  fevers 
in  general,  and  that  no  account  was  taken  of  individual 
deviations  within  the  limits  of  this  group.  Whereas,  in 
point  of  fact,  he  perceived  what  is  well  known  within  the 
profession  and  without  it,  that  although  bark  is  really  the 
specific  for  many,  indeed  for  the  majority  of  malarious 
fevers,  it  is  not  so  for  all ;  since  many  cases  cannot  be  cured 
or  even  improved  by  its  use. 

Now,  this  wholesale  way  of  regarding  diseases,  in  groups, 
was  the  logical  and  inevitable  consequence  of  the  Old  School 
theories  of  disease  and  of  the  method  of  cure.  When  Galen 
propounded  the  doctrine  that  all  diseases  depend  upon  one 
of  four  conditions,  heat,  cold,  dryness,  moisture,  it  was  an 
inevitable  consequence  that  he  should  disregard  every  phe- 
nomenon presented  by  his  patients,  except  such  as  served 
to  indicate  that  the  case  belonged  to  one  of  the  above  cate- 
gories, and  that  he  should  have  but  four  classes  of  remedial 
agents  appropriate  to  these  categories. 

And  when,  in  our  day,  physicians  assume  to  ascribe  dis- 
eases to  certain  pathologico-anatomical  states  as  their  essen- 
tial causes,  it  is  manifest  that  whatever  varieties  the  case  of 
each  one  of  a  dozen  patients  may  present,  must  be  disre- 
garded, provided  the  pathologico-anatomical  condition  be 
the  same  in  all,  for  they  are  grouped  on  the  basis  of  this 
condition,  and  the  indication  for  the  cure  is  drawn  from  the 
existence  of  this  condition,  and  must  necessarily  be  the  same 
for  all. 

Now,  just  as  any  spot  upon  the  surface  of  the  globe  may 
be  approached  by  an  almost  infinite  number  of  roads,  and 
yet,  when  the  traveler  has  reached  the  spot,  there  shall  be 
nothing  in  the  mere  fact  of  his  presence  there  to  indicate 
with  certainty  the  road  by  which  he  has  come  thither,  so  the 
same  pathologico-anatomical  result  may  issue  from  the  most 


88  ANTAGONISM   BETWEEN 

multifarious  pathological  processes,  which  processes,  however, 
leave  no  sign  in  the  result.  If,  then,  the  mode  of  treatment 
be  based  on  the  result,  it  can  take  no  account  of  this  variety 
in  \h&  processes. 

A  wholesale  generalization,  then,  of  diseases  and  of  reme- 
dies is  inevitable  from  the  philosophy  of  the  "Rational" 
method. 

The  common  experience  of  the  community  teaches  men 
that  diseases  to  which  the  same  name  is  given  may  present 
in  different  persons  an  entirely  different  aspect.  John  Doe 
and  Richard  Roe  both  have  rheumatism,  but  their  symptoms 
and  whole  condition  are  so  entirely  different  that  no  one 
would  have  imagined  them  to  have  the  same  disease,  if  the 
doctor  had  not  said  so.  The  pathologico-anatomical  condi- 
tion, however,  is  the  same  in  both  (viz.,  the  altered  condition 
of  the  blood),  and  consequently  the  rational  indications  for 
the  cure  are  identical  in  the  two  cases.  If  the  doctor  be 
true  to  the  philosophy  of  his  method,  he  treats  them  alike, 
notwithstanding  the  difference  in  their  symptoms  and  ap- 
parent condition.  But  I  call  your  attention  to  the  fact  which 
is  familiar  to  every  one,  that  every  sagacious  and  long- 
headed physician  of  the  Old  School  pays  the  less  regard  to 
the  rules  of  his  art  the  more  experience  he  acquires  at  the 
bedside. 

In  treating  disease  he  "  feels  his  way,"  as  the  saying  is; 
he  relies  on  his  "  practical  tact  and  experience,"  and  often 
deviates  widely  from  the  rules  of  practice  as  they  are  deduced 
in  the  books  from  the  theory  of  the  art ;  he  trusts  less  and 
less  implicitly  to  a  pathologico-anatomical  basis  of  treatment, 
and  more  and  more  to  "  general  indications,"  by  which  he 
means  the  sum  of  the  symptoms  of  each  individual  case. 
In  truth,  experience  has  taught  him  the  fallacy  of  the  science 
of  therapeutics,  as  founded  on  the  "  Rational "  basis. 

Now,  if  this  were  a  true  science,  would  not  experience 
rather  confirm  the  practitioner's  faith  in  it,  and  add  to  his 
skill  in  applying  it  ? 


HOMCEOPATHY   AND   ALLOPATHY.  89 

When  on  the  other  hand  we  cast  aside  all  endeavors  to 
base  a  method  of  treatment  upon  a  theory  of  disease;  when 
we  give  over  all  attempts  to  discover  the  inscrutable,  essen- 
tial nature  and  cause  of  diseases,  and  confine  our  observa- 
tions to  the  phenomena  of  morbid  action,  whether  these  be 
material  or  functional,  then  we  can  take  into  account  the 
pathological  processes  as  well  as  the  pathologico-anatomical 
results.  We  are  then  in  condition  to  give  due  weight  to  the 
peculiarities  of  each  individual  case  of  disease,  to  study  it, 
as  under  other  circumstances  groups  are  studied,  and  to  give 
due  attention  to  the  modifying  idiosyncrasies  of  the  indi- 
vidual. 

Hence,  under  our  method  alone  is  an  absolute  individual- 
ization  of  disease  possible.  Such  a  method  of  studying  dis- 
ease, however,  would  be  barren  under  the  Old  School  method 
of  treatment,  even  with  specifics.  For  the  properties  of  spe- 
cifics were  known  to  the  Old  School  only  with  reference  to 
large  and  ill-defined  groups  of  diseases.  By  us,  on  the  other 
hand,  specifics  are  studied  in  the  effects  which  they  produce 
upon  the  healthy  subject,  precisely  as  diseases  are  studied  in 
the  effects  which  morbific  causes  produce  upon  the  sick. 
The  same  strict  individualization,  then,  is  practicable  with 
regard  to  specifics  that  we  have  seen  to  be  necessary  in  the 
study  of  diseases.  It  is  not  only  practicable — it  is  fruitful 
of  the  richest  returns. 

The  case,  therefore,  is  not  half  stated  when  we  say  that 
Hahnemann  discovered  the  method  of  specifics.  He  taught 
us  how  to  discover  and  apply,  and  showed  us  the  necessity  of 
applying,  an  individual  specific  to  each  individual  case  of  dis- 
ease, as  studied  in  the  totality  of  its  phenomena  and  without 
regard  to  the  nosological  group  to  which,  for  purposes  of 
classification,  the  case  might  be  assignable. 

As  a  necessary  consequence  of  this  individualization,  Hah- 
nemann taught  the  value  of  subjective  symptoms.  By  these, 
we  mean  those  symptoms  of  which  the  physician  becomes 
cognizant  through  the  sensibilities  of  the  patient.  Among 


90  ANTAGONISM   BETWEEN 

them  are  all  the  varieties  of  pains  and  abnormal  sensations 
which  accompany  disease.  These  symptoms  were  previously 
disregarded  and  are  still  considered  as  of  no  value  by  the 
"rational"  or  "physiological"  school  of  medicine.  Thus,  Pro- 
fessor Bock,  of  Leipsic,  in  his  work  on  Diagnosis  (1853), 
says  :  "  Only  the  objective  symptoms — of  which  the  prac- 
titioner derives  a  knowledge  by  the  use  of  his  own  five 
senses,  by  sight,  touch,  hearing,  mensuration,  percussion,  and 
by  microscopic  and  chemical  examinations  —  are  of  any 
value  to  the  physician.  The  subjective  symptoms  are  in  the 
highest  degree  uncertain  and  treacherous."  In  other  words, 
the  disease  is  to  be  studied  in  all  cases  just  as  the  phenomena 
of  an  inanimate  plant  or  mineral  are  studied ;  the  case  of  an 
intelligent  and  self-possessed  patient,  just  as  that  of  a  patient 
whose  intelligence  is  dormant  under  the  cloud  of  a  typhoid 
fever ! 

Now,  everybody  knows  that  pains  and  various  sensations 
different  from  those  of  health,  make  up  a  large  and  impor- 
tant part  in  every  case  of  illness.  And  what  are  these 
sensations  ?  Unquestionably  they  are  the  results  of  abnor- 
mal action  of  the  sentient  nerves,  or  else  they  are  evidences 
conveyed  by  the  sentient  nerves  of  abnormal  action  in  some 
of  the  organs  of  the  body. 

It  is  in  the  highest  degree  unphilosophical  to  arbitrarily 
disregard  and  cast  aside  any  of  the  phenomena  of  disease. 
If  they  find  no  place  in  our  system  of  medicine,  why,  so 
much  the  worse  for  our  system  !  If  they  cannot  be  made 
available  under  our  method  of  treating  disease,  this  fact  is 
prima  facie  evidence  that  our  method  is  defective  !  Fur- 
thermore, every  physician  and  every  intelligent  person 
knows,  by  observation  and  experience,  that  pains  and  abnor- 
mal sensations  almost  always  precede  any  material  or 
organic  evidence  of  disease.  Common  sense  teaches  every 
man  the  value,  in  medical  treatment,  of  the  maxim,  "  Obsta 
principiis ! "  Diseases  should  come  under  treatment  at 
the  earliest  possible  moment.  Some  that  are  curable  at  an 


HOMOEOPATHY   AND   ALLOPATHY.  91 

early  period  are  well  known  to  be  incurable  by  our  present 
resources,  if  allowed  to  establish  themselves  firmly.  But 
the  first  evidences  of  nearly  all  diseases  consist  of  subjective 
symptoms.  A  method,  therefore,  which  does  not  provide 
for  the  employment  of  these  symptoms  in  the  determination 
of  the  treatment,  cannot  furnish  means  for  encountering  dis- 
ease at  the  very  outset. 

And,  appealing  again  to  the  experience  of  the  community 
to  bear  me  out,  I  say  that  honest  and  candid  practitioners 
of  the  Old  School  often  say  to  their  patients,  "  Wait  a  little 
until  your  disease  shall  have  become  developed, — at  present 
I  know  not  what  to  do."  Why  does  he  not  know  what  to 
do  ?  This  question  touches  the  weak  point  in  the  philoso- 
phy of  the  physiological  school.  It  is  because  the  patient, 
as  yet,  presents  only  "subjective  symptoms,"  which  are 
evidence  of  "  dynamic  changes  "  only, — because  he  cannot 
form  a  theory  of  the  cause  of  the  disease  until  the  disease 
has  progressed  far  enough  to  furnish  him  with  some  material 
results  of  these  dynamic  changes, — in  a  word,  with  objective 
symptoms.  This  instance  is  another  evidence  of  the  insuf- 
ficiency of  the  Old  School  philosophy  of  medicine,  while  at 
the  same  time  it  shows  that,  so  long  as  they  accept  this 
philosophy,  the  physiological  school  are  consistent  and 
logical  in  excluding  subjective  symptoms  from  consideration. 

Not  a  few  diseases — the  neuroses,  for  example — consist 
almost  entirely  of  subjective  symptoms.  In  these,  the  phys- 
iological physician  admits  his  inability  to  institute  a  rational 
treatment,  and  he  resorts  at  once  to  specifics.  But  if  the 
specific  method  of  treatment  is  available  against  diseases  for 
which  the  physiological  method  fails,  as  well  as  for  all  other 
cases,  is  it  not  confessedly  the  universal  method  ? 

Hahnemann's  method,  which  avails  itself  of  all  the  phe- 
nomena which  the  patient  presents,— holding  that  all, 
together,  make  up  the  disease,— sets  a  true  value  upon  sub- 
jective symptoms.  Not  requiring  a  theory  of  the  nature 
and  cause  of  the  disease  as  a  preliminary  to  the  treatment, 


92  ANTAGONISM   BETWEEN 

but  basing  the  treatment  directly  upon  the  phenomena  which 
the  patient  presents,  it  can  proceed  to  cure  a  patient  who 
presents  only  subjective  symptoms  as  readily  and  as  surely 
as  one  in  whom  these  have  given  place  to  objective  symp- 
toms. 

More  than  this,  Hahnemann  showed  the  value  of  sub- 
jective symptoms  in  the  aid  which  they  afford  us  in  indi- 
vidualizing cases  of  disease,  and  thereby  enabling  us  to 
select  a  specific  for  each  individual  case  with  more  absolute 
precision.  Indeed,  he  showed  that  it  is  only  by  means  of 
subjective  symptoms  that  the  application  of  individual  spe- 
cifics is  possible.  It  has  already  been  remarked  that  the 
material  or  organic  changes  in  the  tissues  of  the  body, 
which  furnish  the  objective  symptoms,  may  have  resulted 
from  any  one  of  a  number  of  pathological  processes  or 
abnormal  alterations  of  function,  and  that  they  give  us  in 
themselves  no  means  of  knowing  from  what  particular  abnor- 
mal process  they  resulted.  Now,  unless  we  know  this,  we 
cannot  apply  specifics  with  exactness.  The  physiological 
school  have  no  means  of  knowing  it,  and  therefore  they, 
very  logically,  do  not  undertake  to  apply  specifics  with 
exactness  to  individualize  cases  of  disease.  But  the  subjective 
symptoms  enable  us  to  take  cognizance  of  these  patho- 
logical processes,  these  abnormal  changes  of  function,  and 
hence  the  value  of  these  symptoms.  To  Hahnemann 
belongs  the  honor  of  having  demonstrated  this  value,  and 
of  having  shown  us  how  to  avail  ourselves  of  it. 

To  Hahnemann,  again,  belongs  the  credit  of  having 
insisted  upon  the  propriety  of  using  only  one  remedy  at  a 
time.  As  this,  however,  was  clearly  expressed  by  Boyle, 
and  is  admitted  by  Sir  John  Forbes,  I  shall  content  myself 
with  quoting  their  words.  Boyle  says  (1654):  "  It  seems 
a  great  impediment  to  the  further  discovery  of  the  virtues  of 
simples,  to  confound  so  many  of  them  in  compositions ;  for 
in  a  mixture  of  a  great  number  of  ingredients,  it  is  hard  to 
know  what  is  the  operation  of  each  or  any  of  them,  so  that 


HOMOEOPATHY   AND   ALLOPATHY.  93 

I  fear  there  will  scarce,  in  a  long  time,  be  any  progress  made 
in  the  discovery  of  the  virtues  of  simple  drugs,  till  they  either 
be  oftener  employed  singly  or  be  but  few  of  them 
employed  in  a  single  remedy."  And  Forbes  says,  in 
1846:  "Our  system  here  is  greatly  and  radically  wrong. 
Our  officinal  formulae  are  already  most  absurdly  complex, 
and  our  fashion  is  to  double  and  redouble  the  existing  com- 
plexities. This  system  is  a  most  serious  impediment  in  the 
way  of  ascertaining  the  precise  and  peculiar  powers  (if  any) 
of  the  individual  drugs,  and  thus  interferes  in  the  most 
important  manner  with  the  progress  of  therapeutics." 

And,  finally,  Hahnemann  demonstrated  these  facts : 

1st.  That  the  curative  power  of  a  specific  remedy  is  not  in 
the  direct  ratio  of  its  material  quantity.  This  had  been  sus- 
pected by  his  predecessor  Sydenham,  with  respect  to  bark. 

2d.  That  a  drug  exerts  a  more  powerful  effect  on  those 
organs  for  which  it  has  a  specific  affinity  when  these  organs 
are  sick  than  when  they  are  healthy  ;  whence  it  follows  that 
smaller  doses  of  the  same  drug  are  required  to  cure  diseases 
for  which  it  is  the  specific  remedy,  than  would  be  needed  to 
produce  their  symptoms  in  the  healthy  person. 

3d.  That  not  only  are  smaller  doses  of  specifics  required 
to  cure  diseases  than  to  produce  their  symptoms  in  the 
healthy,  but  that,  when  the  symptoms  of  the  diseased  organ- 
ism are  similar  to  those  produced  in  the  healthy  subject  by 
a  given  drug,  then  this  drug  will  act  curatively  on  that 
organism  in  doses  so  small  that  they  would  hardly  produce 
any  effect  whatever  on  the  healthy  organism. 

But  how  small  ?  This  is  the  practical  question.  A  priori, 
Hahnemann  said,  "The  smaller  the  better,  provided  they 
only  cure  the  disease  in  the  quickest  and  surest  manner." 
He  experimented  for  the  purpose  of  reaching  definite  con- 
clusions, and  out  of  these  facts  and  experiments  came  the 
doctrine  and  practice  of  the  little  doses.  And  I  repeat  that 
those  who  follow  Hahnemann  most  closely,  individualize 
their  cases  most  strictly,  and  select  the  individual  specific 


94  ANTAGONISM   BETWEEN 

with  most  exactness,  will  surely  arrive,  as  all  such  have 
done,  at  the  conclusion,  on  this  subject,  to  which  Hahne- 
mann  came. 

It  is  remarkable  that  the  first  and  second  facts  I  mentioned 
respecting  the  dose  of  specifics  did  not  escape  the  acute  mind 
of  Robert  Boyle.  He  says  :  "To  show  you  that  a  distem- 
pered body  is  an  engine  disposed  to  receive  alterations 
under  such  impressions  as  will  make  none  upon  a  sound 
body,  let  me  put  you  in  mind  that  those  subtle  streams 
that  wander  through  the  air  before  considerable  changes  of 
weather  disclose  themselves,  are  wont  to  be  painfully  felt  by 
many  sickly  persons,  and  more  constantly  by  men  that  have 
had  great  bruises  or  wounds,  in  the  parts  that  have  been  so 
hurt, — though  neither  are  healthy  men  at  all  incommoded 
thereby,  nor  do  those  themselves  that  have  been  hurt  feel 
anything  in  their  sound  parts  whose  tone  or  texture  has  not 
been  altered  or  enfeebled  by  outward  violence." 

If  quantity  be  accepted  as  the  measure  of  power,  then  the 
question  of  the  dose  must  be  resolved  by  the  well-known 
laws  of  physics. 

But  so  soon  as  it  is  admitted  that  the  power  of  a  drug  is 
not  determined  by  its  quantity  alone,  but  also  by  its  form, 
and  still  more  by  the  condition  of  the  patient  and  by  the  rela- 
tion of  the  specific  properties  of  the  drug  to  the  diseased 
condition  against  which  it  is  administered,  then  the  whole 
question  is  withdrawn  from  the  domain  of  physics  and  is  left 
open  to  be  settled  by  experiment. 

Now,  it  is  admitted  by  all  medical  men,  that  some  drugs 
at  least,  exert  their  specific  influence  more  speedily  and  more 
powerfully  when  given  in  small  doses  than  when  given  in  large 
doses,  as,  for  example,  Mercury,  and  according  to  Dr.  Chris- 
tison,  Oxalic  acid,  which  shows  that  there  is  not  always  a 
direct  ratio  between  power  and  quantity. 

Moreover,  all  medical  men  agree  that  in  certain  morbid 
states,  the  body  is  much  more  sensitive  to  the  specific  action 
of  certain  remedies  than  it  is,  in  certain  other  morbid  states, 


HOMOEOPATHY   AND   ALLOPATHY.  95 

to  the  same  remedies.  The  phrase  that  "such  or  such  a 
disease  does  not  bear  Mercury  well,"  is  familiar  to  the  pro- 
fessional ear.  This  shows  that  the  condition  of  the  patient 
has  something  to  do  in  determining  the  power  with  which  a 
certain  dose  of  a  specific  shall  manifest  its  action,  and  con- 
versely that  this  condition  should  be  taken  into  consideration 
in  determining  the  dose. 

These  two  facts  show  that  the  whole  question  of  the  dose 
was,  at  the  time  of  Hahnemann's  writing,  an  open  one,  to 
be  settled  by  experiment  alone. 

And,  as  Hahnemann  showed  that  those  morbid  conditions 
of  the  system  in  which  a  specific  exerts  the  most  power  in 
small  doses, — in  which,  in  other  words,  the  susceptibility  of 
the  system  to  the  specific  is  the  greatest, — are  precisely  those 
in  which  the  symptoms  are  similar  to  those  which  the  same 
drug  would  produce  in  a  healthy  person,  it  follows  that  no 
experiment  can  be  valid  on  the  subject  of  the  dose  which 
does  not  take  into  consideration  the  condition  of  the  patient 
at  the  time,  and  which  does  not  require,  as  preliminary  con- 
ditions, first,  that  the  subject  of  the  experiment  shall  be  sick, 
and  second,  that  the  symptoms  of  the  sickness  shall  be  simi- 
lar to  those  which  the  drug  with  which  the  experiment  is 
made  would  produce  on  the  healthy  subject. 

In  none  of  the  experiments  on  which  our  opponents  base 
their  objections  to  the  dose  of  Homoeopathy  have  these  con- 
ditions been  observed. 

In  no  case  in  which  they  have  been  observed  has  the 
result  been  adverse  to  that  at  which  Hahnemann  arrived. 

But,  in  truth,  these  objections  depend  in  general  not  so 
much  on  the  result  of  experiments  as  on  what  is  -called  the 
a  priori  improbability,  and  upon  the  seeming  simplicity  and 
triviality  of  the  means  employed  in  proportion  to  the  end 
sought  to  be  attained. 

The  improbability  exists  only  in  the  minds  of  those  who 
reckon  respecting  the  living  organism  as  they  reckon  respect- 
ing an  inanimate  machine,  employing  the  rules  of  physics. 


96  ANTAGONISM   BETWEEN 

Let  me  quote  again  from  Boyle:  "Whereas,"  he  says,  "it 
is  objected  that  so  small  a  quantity  of  the  matter  of  a  specific 
as  is  able  to  retain  its  nature,  when  it  arrives  at  the  part  it 
should  work  on,  must  have  little  or  no  power  to  relieve  it ; 
this  difficulty  will  not  stagger  those  who  know  how  unsafe 
it  is  to  measure  the  power  that  natural  agents  may  have  to 
work  upon  such  an  engine  as  the  human  body  by  their 
bulk,  rather  than  by  their  subtlety  and  activity." 

And  as  concerns  the  relative  simplicity  and  triviality  of 
the  dose,  listen  to  the  practical  Sydenham. 

Speaking  of  the  success  of  his  new  plan  of  treating  rheuma- 
tism with  whey,  instead  of  by  blood-letting,  he  says : 
41  Should  any  one  despise  this  method  for  its  simplicity,  I 
would  have  him  to  know  that  weak  minds  only,  scorn  things 
for  being  clear  and  plain.  *  *  *  The  usual  pomp  of 
medicine  exhibited  over  dying  patients  is  like  the  garlands 
of  a  beast  at  the  sacrifice."  x 

Gentlemen  of  the  Society :  In  the  torch- races  of  ancient 
Greece  the  participants  ran  with  lighted  torches,  each  striv- 
ing to  preserve  the  flame  alive,  and  to  hand  his  torch  unex- 
tinguished  to  his  successor.  If  the  light  went  out  in  his 
hands  he  was  dishonored.  This  was  done  in  memory  of 
Prometheus,  who  first  brought  fire  from  heaven  for  the 
benefit  of  men. 

We  have  received  from  the  generation  of  the  pupils  and 
successors  of  Hahnemann  the  blazing  torch  which  the 
Prometheus  of  our  system  lighted  at  the  altar  of  Eternal 
Truth.  Our  honor  depends  on  the  care  with  which  we 
cherish  it,  and  the  state  in  which  we,  in  turn,  transmit  it  to 
those  who  shall  follow  us. 

The  especial  direction  which  our  labors  should  take  is 
determined  by  the  peculiarities  of  our  method. 

We  are  to  increase  the  number  of  specific  remedies.  We 
are  to  labor  diligently,  as  our  predecessors  have  done,  to 
increase  our  materia  medica,  until  we  shall  have  ascertained 

1  Russell,  History  and  Heroes  of  the  Art  of  Medicine. 


HOMOEOPATHY   ANP   ALLOPATHY.  97 

the  specific  remedial  properties  of  all  substances  capable  of 
being  used  in  treating  diseases. 

But  more  especially  are  we  to  labor  to  make  the  knowl- 
edge we  thus  acquire  of  new  specifics,  and  the  knowledge 
we  already  possess  of  such  as  we  now  use,  more  exact  and 
definite ;  until  we  shall  possess  an  exhaustive  knowledge 
of  each  remedy,  and  also  such  a  differential  knowledge  as 
shall  put  us  in  possession  of  all  the  points  of  resemblance 
and  difference  between  each  of  our  remedies  and  all  the 
rest. 

And  it  is  in  this  particular  province  that  there  is  the 
greatest  present  need  of  labor.  Our  materia  medica  is  being 
filled  with  the  names  of  drugs  of  which  a  few  general  proper- 
ties are  loosely  recorded,  but  respecting  which  no  exact  or 
exhaustive  knowledge  has  been  attempted  to  be  gained. 
All  this  must  be  changed  if  we  would  establish  and  maintain 
a  reputation  at  all  commensurate  with  the  demands  of 
modern  science. 

Finally,  we  must  bring  to  bear  upon  our  study  of  materia 
medica  and  of  symptomatology  all  that  is  useful  in  the 
labors  of  the  physiological  school  of  medicine,  in  the  depart- 
ment of  the  collateral  medical  sciences  of  physiology,  pathol- 
ogy, chemistry  and  physical  diagnosis. 

For,  chaotic  as  are  the  therapeutics  of  this  school,  and 
based  on  a  false  philosophy,  we  must  not  suffer  this  fact  to 
blind  us  to  the  wonderful  progress  made  by  it  in  these 
collateral  sciences,  and  which  are  as  valuable  to  us  as  to  it. 

They  supply  the  means  of  exact  observation.  We  need, 
then,  in  part,  to  reprove  our  materia  medica,  availing  our- 
selves of  these  improved  means  of  observation;  and  we 
must  employ  the  same  in  our  examination  of  the  sick. 

We  are  called  also  to  give  ourselves  to  the  study  of  sub- 
jective symptoms.  This  is  our  especial  province,  because 
the  physiological  school  discards  these  symptoms.  Prof. 
Bock  says  they  are  "difficult  to  understand  and  apt  to 
deceive." 


98     ANTAGONISM  BET.  HOMCEOPATHY  AND  ALLOPATHY. 

I  have  yet  to  learn  that  a  study  is  to  be  avoided  because 
it  is  difficult !  or  that  a  precious  tool  should  be  cast  aside 
because  it  requires  a  skillful  hand  to  use  it.  • 

The  import  of  subjective  symptoms,  their  connection  with 
each  other,  their  physiological  and  pathological  significance, 
are  all  matters  which  it  is  indispensably  necessary  for  us  to 
elaborate  and  master. 

And,  last  of  all,  the  still  open  question  of  the  dose 
demands  our  earnest  study. 

Conscientious,  untiring  labor  in  these  departments  will 
enable  us  to  hold  with  honor  our  place  in  the  great  race, 
and  to  hand  our  torch,  still  blazing,  to  our  successors. 

We  shall  thus  do  our  part  toward  making  good  the  confi- 
dent expectation  of  our  master  respecting  his  system. 

"  Our  art,"  says  he,  "  needs  no  political  lever,  no  worldly 
badges  of  honor,  in  order  to  become  something.  Amid  all 
the  rank  and  unsightly  weeds  that  flourish  round  about  it, 
it  grows  gradually  from  a  small  acorn  to  a  slender  tree ; 
already  its  lofty  summit  overtops  the  rank  vegetation  around 
it.  Only  have  patience  !  It  strikes  its  roots  deep  under 
ground,  gains  strength  imperceptibly,  but  all  the  more  cer- 
tainly, and  in  due  time  it  will  grow  up  to  a  lofty  God's  oak, 
stretching  its  great  arms,  that  no  longer  bend  to  the  storm, 
far  away  into  all  the  regions  of  the  earth ;  and  mankind, 
who  have  hitherto  been  tormented,  will  be  refreshed  under 
its  beneficent  shadows." 


RELATION  OF  PATHOLOGY  TO 
THERAPEUTICS.1 


THE  question  of  the  Relation  of  Pathology  to  Therapeutics 
is  one  of  exceeding  importance,  if  for  no  other  reason  than 
this  :  that,  by  a  very  large  portion  of  the  medical  profession, 
it  is  commonly  held  that  the  whole  science  of  Therapeutics 
is  based,  in  its  general  principles  and  in  its  special  applica- 
tions, upon  the  science  and  the  facts  of  Pathology. 

Before  beginning  the  discussion  of  this  subject,  it  is  neces- 
sary to  define  the  terms  used  in  stating  the  question,  as  well 
as  certain  kindred  terms. 

The  study  of  the  tissues  and  organs  of  which  the  healthy 
human  body  is  composed  constitutes  the  science  of  Physi- 
ological Anatomy.  It  may  be  pursued  upon  the  living  or 
the  dead  body,  provided  the  death  resulted  from  violence  and 
not  from  disease. 

The  tissues  and  organs  of  the  healthy  body  are  so  fashioned 
as  to  perform,  each,  a  special  work.  This  act  of  performing 
its  special  work  is  called  the  function  of  an  organ.  An 
organ  can  act  only  during  the  life  of  the  individual.  Func- 
tions, therefore,  can  be  predicated  only  of  living  organs.  The 
study  of  the  performance  of  their  special  work  by  the  aggre- 
gation of  organs  which  make  up  the  body  constitutes  the 
science  of  Physiology. 

Physiological  Anatomy,  then,  is  the  science  of  the  tissues 
and  organs  of  the  healthy  body ;  Physiology  is  the  science  of 
the  functions  of  the  healthy,  living  organism. 

When  any  or  all  of  the  tissues  or  organs  of  the  body  have 
suffered  modifications  of  substance  or  of  structure  in  conse- 

1  Read  before  the  Homoeopathic  Medical  Society  of  the  State  of  New-York, 
May,  1863. 


100  RELATION   OF   PATHOLOGY 

quence  of  disease,  the  study  of  these  material  changes,  which 
are  the  results  of  disease,  constitutes  the  science  of  Patho- 
logical Anatomy.  This  maybe  studied  upon  the  living  or 
the  dead  diseased  organism. 

When,  in  consequence  of  the  action  of  a  morbific  agent, 
any  or  all  of  the  organs  of  the  body  perform  their  special 
work  in  an  abnormal  manner ;  in  other  words,  when  the 
function  of  any  of  the  organs  of  the  body  is  perverted,  the 
study  of  these  changes  and  perversions  of  function  constitutes 
the  science  of  Pathology,  which,  like  Physiology,  can  be 
studied  only  in  the  living  organism. 

Pathological  Anatomy,  then,  is  the  science  of  the  morbid 
tissues  and  organs  of  the  diseased  body.  Pathology  is  the 
science  of  the  abnormal  functions  of  the  diseased  living  body. 

Diseased  tissues  and  organs  being  modifications  of  healthy 
tissues  and  organs,  it  is  clearly  necessary  to  understand 
Physiological  Anatomy  before  we  can  understand  Patho- 
logical Anatomy.  Just  as  necessary  is  it,  for  the  same  reason, 
to  understand  Physiology  before  we  can  master  Pathology. 
Indeed  the  latter  might  be  said  to  exist  only  by  comparison 
with  the  former. 

If  this  be  true  of  the  details  of  these  sciences,  it  is  no  less 
true  of  their  essential  nature  and  philosophy.  If  one  would 
gain  a  correct  notion  of  the  subject,  scope,  limits  and  rela- 
tions of  the  science  of  Pathology,  he  must  first  have  a  just 
and  exact  idea  of  those  of  Physiology.  To  the  latter,  there- 
fore, I  propose  to  devote  a  few  words. 

Dr.  Carpenter  defines  the  object  of  Physiology  to  be  the 
study  of  "the  phenomena  which  normally  present  them- 
selves during  the  existence  of  living  beings,"  or,  in  another 
place,  "the  phenomena  of  health  or  normal  life." 

Its  object,  then,  is  not,  as  it  has  been  sometimes  loosely 
stated,  life  itself,  but  the  phenomena  which  depend  upon  and 
result  from  normal  life.  The  science  of  Physiology  brings 
these  phenomena  into  systematic  form,  classifies  and  com- 
pares them,  analyzes  secondary  and  complex  phenomena  into 


TO  THERAPEUTICS.  IOI 

their  simple  elements,  and  seeks  the  ultimate  phenomenon 
in  which  the  real  elementary  manifestation  of  simple  life  is 
made,  uncomplicated  by  secondary  or  related  chemical  or 
mech'anical  phenomena. 

Virchow  says,  "  The  chief  point  is  to  obtain  a  recognition 
of  the  fact  that  the  cell  is  really  the  ultimate  morphological 
element  in  which  there  is  any  manifestation  of  life,  and  that 
we  must  not  transfer  the  seat  of  real  vital  action  to  any  point 
beyond  the  cell."1 

Dr.  Carpenter  says,  "The  cell  lives  for  itself  and  by  itself, 
and  is  dependent  upon  nothing  but  a  due  supply  of  nutri- 
ment and  a  proper  temperature  for  the  continuance  of  its 
growth,  and  for  the  due  performance  of  its  functions  until  its 
term  of  life  expires.  Its  chief  endowment  seems  to  be  that 
of  attracting  or  drawing  to  itself  some  of  the  various  sub- 
stances which  are  contained  in  the  nutritive  fluid  in  relation 
with  it.  This  fluid  is  a  mixture  of  a  great  number  of  com- 
ponents ;  and  different  sets  of  cells  appear  destined  severally 
to  appropriate  these.  As  far  as  is  yet  known,  however,  the 
composition  of  the  cell-wall  is  everywhere  the  same,  being 
that  of  Proteine." 

Dr.  J.  H.  Bennett  says,  "  Nutrition  is  now  considered  to 
depend  upon  an  inherent  vital  property  peculiar  to  the  tissues 
themselves,  which  exercise  a  force  at  the  same  time  attract- 
ive and  selective.  By  its  agency  each  tissue  and  gland 
attracts  from  the  blood  that  amount  of  matter  which  is 
necessary  to  maintain  it  in  bulk,  and  at  the  same  time  selects 
from  it  the  peculiar  substance  necessary  for  itself  and  for  the 
secretion  it  is  destined  to  produce." 

According,  then,  to  the  most  advanced  writers  on  this  sub- 
ject, we  are  to  regard  the  organism  as  a  complex  which  is 
capable  of  being  analyzed  into  an  aggregation  of  cells,  of 
homogeneous  structure,  but  each  of  which  is  endowed  with  a 
peculiar  inherent  vital  power  of  "  attraction  and  selection," 
which  we  recognize  only  in  its  results  and  which  constitutes 
the  only  "  real  action  of  life"  that  we  are  capable  of  observing. 

Cell.  Path.,  Eng.  ed.,  3. 

CQLL'EG 


102  RELATION  OF   PATHOLOGY 

In  the  words  of  Virchow,  "  Every  animal  presents  itself  as  a 
sum  of  vital  unities,  every  one  of  which  manifests  all  the 
characteristics  of  life." 

Life,  then,  really  consists  in  the  exercise  by  each  cell  of 
its  inherent  peculiar  attractive  and  selective  power.  Physi- 
ology concerns  herself  with  the  results  of  this  exercise.  A 
cell  by  virtue  of  its  inherent  power  abstracts  from  the  nutri- 
ent fluid  a  substance  which  is  to  serve  to  nourish  the  organ 
to  which  the  cell  belongs,  or  to  furnish  the  secretion  of  that 
organ.  If  the  former,  then  the  future  history  of  that  organ, 
its  development,  its  functions  and  its  interstitial  decline  and 
dissolution  and  the  fate  of  its  debris  belong  to  the  secondary 
and  complex  phenomena  to  which  Physiology  devotes  her- 
self. With  these  phenomena,  life  has  no  exclusive  connec- 
tion save  in  the  primary  exertion  by  the  cell-wall  of  its 
"  inherent  attractive  and  selective  power." 

Physiologists  with  great  propriety  attempt  to  explain  by 
mechanical,  chemical  and  electrical  laws  the  secondary  phe- 
nomena of  the  organism,  the  relations  of  different  tissues  and 
secretions  to  each  other  and  their  mutual  reactions.  But 
they  make  no  attempt  to  explain  the  action  of  the  cell-wall 
which  is  the  ultimate  and  essential  phenomenon  of  life.  They 
accept  this  as  an  ultimate  fact,  they  recognize  a  power  pecu- 
liar to  the  wall  of  each  variety  of  cell  and  different  from 
that  of  any  other  cell,  and  they  deal  with  the  results  of  the 
exercise  of  this  power. 

Physiology  having  been  defined  as  the  science  of  the  phe- 
nomena of  normal  life,  Pathology  has  been  declared  by  the 
same  writer  (Dr.  Carpenter),  to  be  the  science  of  the  phe- 
nomena of  "  disease  or  abnormal  life" 

If  the  mutual  reaction  of  two  secretions  be  different  in  any 
individual  case  from  that  which  is  observed  in  the  healthy 
organism,  one  or  other  of  the  secretions  must  be  of  an  abnor- 
mal character.  This  must  have  resulted  from  an  abnormal 
exercise  by  the  cell- wall  of  that  inherent  selective  power,  by 


TO  THERAPEUTICS.  1 03 

virtue  of  which  the  secretion  was  made.  The  essential  and 
ultimate  act  of  disease  is  found,  like  that  of  life,  to  consist 
in  some  abnormal  exercise  by  the  cell-wall  of  its  inherent 
vital  power.  As  we  recognize  the  existence  of  this  power 
in  the  healthy  cell  only  through  its  action  and  its  result, 
viz.,  the  function  of  secretion  and  the  substance  secreted,  so 
we  recognize  disease,  which  is  an  abnormal  exercise  of  this 
power,  only  through  its  action,  viz.,  the  perverted  function, 
and  through  its  result,  viz.,  an  abnormal  secretion. 

"Not  unfrequently,"  says  Dr.  Bennett,  "this  attractive 
and  selective  power  in  the  tissues  is  deranged,  producing 
increase  or  diminution  in  growth  or  secretion,  general  or 
partial.  Not  unfrequently  the  selective  power  appears  to  be 
lost,  and  the  attractive  power  much  increased,"  etc.,  etc. 
From  this  alteration  of  these  forces,  diseased  conditions 
of  these  fluids  and  tissues  result.  The  secondary  and  com- 
plex phenomena  resulting  from  the  reaction  of  abnormal 
tissues  are  analyzed  by  Pathology  and  referred  to  this 
elementary  deviation  in  the  selective  and  attractive  forces 
of  the  cell- wall.  But  the  nature  and  intimate  cause  of  this 
alteration,  which  is,  however,  the  essence  of  disease,  Pathol- 
ogy does  not  attempt  to  explain  or  apprehend,  knowing  it 
only  by  its  effects. 

As,  therefore,  Physiology  concerns  herself  with  the  results 
of  life,  so  does  Pathology  take  cognizance  of  the  results 
of  disease.  For  it  must  be  repeated  that  as  the  functions  of 
healthy  organs  and  the  tissues  of  the  healthy  body  which 
are  respectively  the  subjects  of  Anatomy  and  Physiology 
are  not  life,  but  only  results  of  life,  so  the  abnormal  func- 
tions and  the  altered  tissues  of  the  diseased  body,  which  are 
respectively  the  subjects  of  the  science  of  Pathology  and 
Pathological  Anatomy  are  not  disease  itself,  but  only  the 
results  of  disease. 

These  distinctions,  it  will  be  perceived,  have  a  direct  and 
most  important  bearing  upon  the  science  of  Therapeutics, 
which  has  for  its  object  the  cure  of  disease. 


104  RELATION   OF   PATHOLOGY 

The  process  by  which  the  secretion  of  any  fluid  of  the 
body  is  accomplished  cannot  be  explained.  It  is  an  exer- 
tion of  that  peculiar  vital  power  of  which  we  have  spoken 
as  inherent  in  the  cell- wall.  The  secretion  of  the  gastric 
juice  and  of  the  bile,  for  example,  is  wholly  inexplicable. 
But  when,  after  being  secreted,  these  or  similar  fluids  are 
brought  into  contact  with  each  other  or  with  any  foreign 
substance,  whether  within  or  without  the  body,  the  actions 
and  reactions  which  ensue  are  explicable  by  chemical, 
mechanical  or  electrical  laws,  and  these  explanations  con- 
stitute the  object  of  Physiology.  It  is  obvious  that  these 
phenomena  may  be  of  great  complexity  and  that  the 
explanations  may  require  to  state  the  conditions  of  several 
successive  series  of  reactions,  which  intervene  between  the 
external  fact  or  symptom  as  viewed  by  the  observer,  and 
that  ultimate  action  of  the  cell-wall  which  Virchow  declares 
to  be  "the  only  real  vital  action  of  the  living  organism" — 
or,  on  the  other  hand,  the  phenomena  may  be  simple  and 
the  explanation  may  be  complete  by  a  simple  and  direct 
reference  to  the  selective  action  of  the  cell- wall.  Thus,  for 
example,  the  fact  of  salivation,  as  noticed  by  an  external 
observer,  is  made  up  of  the  discharge  of  the  salivary  secre- 
tion into  the  mouth.  The  explanation  refers  us  at  once 
to  that  selective  power  of  the  cell-wall  of  the  salivary  glands 
which  extracts  from  the  nutritive  fluids  the  constituents  of 
this  peculiar  secretion  which,  as  such,  is  not  found  any- 
where in  the  body  except  in  the  salivary  ducts  as  the  result 
of  the  process  we  have  just  described. 

On  the  other  hand,  the  fact  of  urination  is  made  up,  so 
far  as  the  external  observer  is  concerned,  of  the  discharge  of 
urine  from  the  urethra  and  the  emptying  of  the  urinary 
bladder.  The  physiological  investigation,  however,  shows 
the  process  to  be  quite  complicated,  and  the  explanation 
carries  us  through  several  series  of  phenomena,  before  we 
arrive  at  the  ultimate  fact.  Thus,  we  trace  the  urine  through 
its  reservoir,  the  bladder,  up  the  ureters  to  the  tubuli  of  the 


TO  THERAPEUTICS. 


105 


kidneys,  where  it  has  probably  received,  if  not  the  whole,  at 
least  a  great  portion  of  its  watery  constituents;  and  this 
contribution  may  require  a  further  explanation  by  the 
mechanical  laws  of  endosmosis  and  exosmosis  whereby  this 
constituent  was  separated  from  the  blood.  Not  tracing  this 
constituent  further,  for  the  present,  by  asking;  as  we  should 
logically  be  required  to  do,  how  this  substance  came  to  be 
contained  in  definite  quantity  in  the  blood,  we  seek  the 
other  constituents  of  the  urine  and  find  the  urea  and  possi- 
bly some  other  of  them  eliminated  by  the  Malpighian 
bodies  from  the  blood  through  the  agency  of  the  cell-wall. 
And  yet  even  this  can  hardly  be  called  the  ultimate  vital 
act,  which  will  require  to  be  sought  by  a  still  deeper  analysis. 
For  although  the  cells  of  the  Malpighian  bodies  do  separate 
the  urea  from  the  blood,  yet  they  do  not  manufacture  it 
from  the  constituents  of  that  fluid.  They  find  it  there 
already  formed,  and  an  exhaustive  analysis  of  the  physio- 
logical fact  of  urination  would  require  us  to  seek  the  origin 
of  the  urea  in  the  blood.  This  would  lead  us  jto  the  study 
of  the  nutrition  and  decay  of  the  nitrogenized  tissues,  and 
in  the  cell-walls  of  these  we  should  first  meet  with  that 
ultimate  vital  act,  in  which  alone,  of  all  the  processes  which 
urination  involves,  life,  pure,  simple  and  inexplicable,  is 
concerned. 

Physiology  goes  somewhat  further  than  this  analysis  of 
the  actual  normal  functions  of  the  living  organism.  Under 
the  name  of  Experimental  Physiology  she  not  only  seeks  to 
apply  the  test  of  synthesis  to  her  analysis,  but  she  endeavors 
to  solve  her  problems  by  the  substitution  of  analogous  sub- 
stances for  some  elements  of  the  nutrient  fluid,  or  for  some 
of  the  secretions  of  the  organism,  and  thus  light  is  thrown 
not  merely  on  the  processes  of  the  living  organism,  but  also 
contributions  are  made  to  the  derived  science  of  Patltology. 
• 

Let  us  now  take  a  similar  view  of  the  science  of  Pathology, 
which  deals  with  abnormal  functions  as  Physiology  does  with 


IO6  RELATION   OF  PATHOLOGY 

normal  functions,  and  which  might  almost,  by  a  license  of 
speech,  be  called  the  science  of  Morbid  Physiology. 

The  fact  of  morbid  salivation  is,  to  the  observer  of  object- 
ive occurrences,  only  a  discharge  of  abnormal  salivary  fluid. 
The  pathological  explanation,  like  the  physiological,  leads  us 
to  the  selection  from  the  blood  by  the  cell- wall  of  the  glands 
of  the  substances  out  of  which  it  fabricates  the  salivary 
fluid.  If  the  blood  be  normal  and  yet  the  saliva  be,  as  we 
have  supposed,  abnormal,  then  the  mysterious  power  of  the 
cell-wall  must  have  been  perverted,  altered  or  impaired. 
This  manifestation  of  life  must  have  become  a  manifestation 
of  abnormal  life — which  is  disease.  Here,  then,  is  the  seat 
of  disease — just  where  we  found  the  seat  of  life — in  the 
inherent  attractive  and  selective  power  of  the  cell-wall. 
This,  then,  is  the  nature  of  disease,  a  modification  of  that 
unknown  and  inscrutable  power,  life. 

"Health,"  says  Carpenter,  "  or  normal  life;"  "disease  or 
abnormal  life." 

"Not  unfrequently,"  says  Dr.  Bennett,  "this  attractive 
and  selective  power  in  the  tissues  is  deranged.  Not  unfre- 
quently the  selective  power  appears  to  be  lost  and  the 
attractive  power  greatly  increased,  and  thus,"  after  a  few 
intermediate  steps  described,  "  the  phenomena  which  we 
call  inflammation  ensue." 

To  take,  now,  an  example  of  a  more  complex  series  of 
phenomena,  the  fact  of  the  evacuation  of  morbid  urine, 
simple  as  it  may  appear  to  the  observer  of  external  phe- 
nomena only,  yet  leads  us,  in  our  search  after  the  original 
act  of  "  abnormal  life  "  in  which  the  morbid  excretion  had 
its  origin,  to  examine  first,  whether  the  change  was  purely  a 
chemical  change,  originated  and  effected  while  the  urine  was 
retained  in  its  reservoir,  the  bladder — for  if  so,  it  differs 
little  from  a  corresponding  change  which  occurs  daily  in 
the  "  vase  de  nuit" — secondly,  whether- the  urine  derived  its 
morbid  character  from  the  admixture  of  morbid  secretion, 
or  effusion  from  the  surface  of  the  bladder,  of  the  ureters, 


TO  THERAPEUTICS. 


107 


of  the  pelvis  of  the  kidney,  or  from  the  tubuli ;  from  each  of 
which  it  might  receive  blood,  or  mucus,  or  pus,  or,  perhaps, 
liquor  sanguinis  alone  holding  fibrine  in  solution,  or  finally 
solid  fibrinous  casts;  or,  thirdly,  whether  the  morbid  change 
in  the  urine  came  from  a  loss,  on  the  part  of  the  cell- 
walls  in  the  Malpighian  bodies,  of  their  inherent  vital 
selective  power,  whereby  they  are  enabled  to  separate  from 
the  blood  those  substances  which  it  is  their  province  in 
the  healthy  body  to  separate ;  or,  finally,  whether  the  blood 
no  longer  contains,  as  in  a  normal  state  it  should  do,  those 
elements  which  it  is  the  function  of  the  kidney  cells  to 
eliminate  from  it, — in  other  words,  whether  the  whole  train  of 
processes  which  eventuates  at  last  in  the  evacuation  of 
abnormal  urine,  may  be  traceable  to  an  abnormal  interstitial 
nutrition  and  destruction  of  the  nitrogenized  tissues ;  all 
these  are  questions  which  it  is  the  legitimate  and  very 
useful  business  of  Pathology  to  solve. 

Now,  be  it  observed,  whether  the  cause  be  traced  to 
abnormal  action  in  the  cell  of  bladder,  ureter,  kidney,  or 
in  that  of  the  muscular  or  cerebral  tissue,  we  arrive  always 
at  the  fact  that  as  the  action  of  the  cell-wall  in  the  healthy 
body  constitutes  the  only  real  vital  action  of  the  organism, 
the  only  unmixed  manifestation  of  life ;  so  the  modified  and 
abnormal  action  of  the*cell-wall  in  the  diseased  body  consti- 
tutes the  only  real  action  'of  abnormal  vitality  in  the 
organism  —  the  only  unmixed  manifestation  of  disease. 

It  may  be  objected  that  no  account  has  been  taken  in 
what  we  have  said,  of  the  action  of  the  nervous  system, 
to  which,  nevertheless,  both  in  the  case  of  morbid  saliva- 
tion and  in  that  of  morbid  urine,  the  alteration  in  the  sali- 
vary gland  and  in  the  kidney  respectively  may  have  been 
attributable.  But  this  objection  simply  adds  another  step  to 
the  analysis.  For  every  action  of  any  part  of  the  nervous 
system  involves  an  expenditure  of  a  portion  of  nervous 
substance,  that  is,  a  process  of  interstitial  destruction  and 
reconstruction,  and  this  process  is  effected  only  through  the 


108  RELATION   OF   PATHOLOGY 

attractive  and  selective  power  of  the  cell-wall  of  the  nervous 
tissue.  Thus  are  we  brought  again  face  to  face  with  this 
inevitable  mysterious  power,  the  abnormal  action  of  which 
constitutes  Disease. 

We  are  now  in  a  position  to  discuss  the  relations  of  this 
science  of  Pathology,  which  treats  of  the  phenomena  of  the 
diseased  organism,  to  the  science  of  Therapeutics,  which  pro- 
poses to  cure  disease. 

It  has  been  stated  that  a  large  portion  of  the  medical  pro- 
fession hold  that  the  science  and  practice  of  Therapeutics 
are  based  upon  the  science  and  facts  of  Pathology.  It  is 
held  that  the  explanation  of  the  phenomena  of  the  morbid 
organism,  which  Pathology  furnishes,  gives  the  key  to  the 
procedures  which  should  be  adopted  for  the  restoration  of 
the  morbid  organism  to  a  healthy  condition.  If,  for  example, 
it  be  ascertained  through  the  investigations  which  Pathol- 
ogy makes  for  us,  that  a  certain  series  of  morbid  symptoms 
may  be  traced  to  an  abnormal  condition  of  the  gastric  fluid, — 
a  too  great  acidity,  for  example,  —  "  it  is,"  says  Dr.  Bennett, 
"the  discovery  and  removal  of  such  causes  as  this  that 
constitute  the  chief  indications  of  the  scientific  practitioner." 
Let  us  see  in  what  way  Dr.  Bennett  proposes  that  this 
"  removal "  shall  be  accomplished.  He  says,  supposing 
another  case  :  "  The  capillary  vessels  become  over-distended 
with  blood,  and  the  exudation  t)f  the  liquor  sanguinis  to  an 
unusual  extent  takes  place,  constituting  inflammation.  How 
is  this  to  be  treated  ?  In  the  early  stage,  topical  bleeding, 
if  directly  applied  to  the  part,  may  diminish  the  congestion, 
and  the  application  of  cold  will  check  the  amount  of  exuda- 
tion. But  the  exudation,  having  once  coagulated  outside  of 
the  vessels,  acts  as  a  foreign  body,  and  the  treatment  must 
be  directed  to  furthering  the  transformations  which  take 
place  in  it,  and  facilitating  the  absorption  and  excretion  of 
effete  matter.  This  is  accomplished  by  the  local  application 
of  heat  and  moisture,  the  internal  use  of  neutral  salts  to 
dissolve  the  increase  of  fibrine  in  the  blood,  and  the  employ- 


TO  THERAPEUTICS.  109 

ment  of  diuretics  and  purgatives  to  assist  its  excretion  by 
urine  or  stool." 

In  this  plan  of  treatment,  we  have  a  proposition  to  adopt 
mechanical  measures — blood-letting — for  the  diminution  of 
a  congestion ;  chemical  means — neutral  salts — for  the  solu- 
tion of  the  exudation;  and  mechanical  means  again — 
diuretics — for  the  removal  of  the  dissolved  exudation  from 
the  blood. 

But  it  cannot  fail  to  attract  the  attention  of  every  reader 
that  this  plan  proposes  to  deal  only  with  the  results  of 
disease — not  with  the  disease  itself — for  the  congestion  is  a 
primary  result  of  the  abnormal  action  of  cell- wall,  and  the 
exudation  which  results  from  the  congestion  is  a  secondary 
result  of  the  same  abnormal  action  of  the  cell-wall.  This  is 
clearly  shown  by  Dr.  Bennett's  words  already  quoted,  but 
which  we  again  cite :  "  Not  unfrequently  the  selective  power 
of  the  cell  appears  to  be  lost,  and  the  attractive  power  so 
much  increased,  that  the  liquor  sanguinis  is  drawn  out 
through  the  vessels,  so  that  its  fibrine  coagulates  in  a  mass 
outside  of  them.  This  result,  preceded  or  accompanied  by 
certain  changes  in  the  vessels  themselves,  and  more  or  less 
stagnation  of  the  current  of  the  blood,  constitutes  the 
phenomenon  hitherto  described  as  inflammation." 

It  is  here  most  distinctly  stated,  and  most  conclusively 
shown,  that  the  cause  of  the  phenomena  of  inflammation  lies 
behind  these  phenomena  of  congestion  and  exudation,  and 
is  to  be  found  in  a  modification  of  that  mysterious  vital 
power  of  the  cell- wall.  It  follows  from  this  that  a  treatment 
which  is  addressed  to  these  resultant  phenomena,  and  not  to 
their  cause,  must  be  but  a  palliative  treatment.  It  can  in  no 
sense  be  called  a  radical  or  a  rational  treatment.  To  remove 
or  assist  in  removing  from  the  body  or  any  part  of  it  the 
results  of  morbid  causes  may  alleviate  suffering,  may  enable 
the  patient  to  hold  out  longer  under  disease,  just  as  pumping 
out  a  leaking  ship  may  postpone  the  time  when  she  will 
sink,  may  increase  her  chances  of  getting  into  port  before 


IIO  RELATION  OF   PATHOLOGY 

she  sinks, — may  thus  in  fact  be  the  means  of  saving  her.  But 
as,  certainly,  pumping  is  only  a  palliative  mode  of  treating  a 
leaking  ship — as  the  stoppage  of  the  leak  is  the  only  radical 
treatment  imaginable — so  in  the  case  of  inflammation  the 
only  radical  treatment  would  be  one  which  addressed  itself 
directly  to  the  cell- wall,  and  in  such  a  way  as  to  restore  to 
it  the  just  amount  and  proportion  of  its  now  perverted 
"  inherent  attractive  and  selective  power." 

It  is  evident  that  when  this  had  been  accomplished,  con- 
gestion would  cease  to  be  produced,  and  in  consequence  of 
this  cessation  there  would  be  no  further  exudation.  It 
might  now  be  within  the  province  of  Pathology  to  indicate 
some  mechanical  or  chemical  way  of  aiding  or  hastening  the 
removal  of  the  results  of  disease — the  congestion  and  exuda- 
tion—but this  would  be  only  a  sequel  of  the  curative  treat- 
ment. 

A  curative  treatment,  then,  must  address  itself  directly  to 
the  cell- wall,  which  is  the  ultimate  seat  of  disease.  And 
every  method  which  is  directed  to  the  results  of  disease, 
which  are  the  proper  subjects  of  Pathology  and  Pathological 
Anatomy,  must,  of  necessity,  be  a  palliative  method. 

But,  it  may  be  objected,  we  are  unable  to  plan  any  such 
curative  treatment,  for  the  reason  that  we  do  not  understand 
the  nature  of  this  cell  force,  nor  the  nature  of  its  perversion, 
in  any  case.  To  recur  to  our  simile  of  the  ship  :  it  is  some- 
times impossible  to  find  the  leak,  or,  if  its  location  be  known, 
to  stop  it.  Nothing  remains  but  palliation.  This  statement, 
as  applied  to  disease,  is  correct  in  only  a  few  instances,  the 
number  of  which  is  becoming  continually  diminished  by  the 
progress  of  science.  It  is  true  that  we  do  not  understand 
the  nature  of  the  cell  force,  whether  normal  or  perverted. 
Neither  do  we  understand  the  nature  of  chemical  affinity, 
nor  the  modus  operandi  of  chemical  reaction.  Yet  we  have 
an  experimental  knowledge  of  each,  and  we  know  the 
peculiar  chemical  affinities  and  reactions  of  a  vast  number  of 
bodies. 


TO  THERAPEUTICS.  HI 

In  like  manner  we  may  learn  the  reaction  of  foreign 
bodies  introduced  into  the  circulation  upon  the  inherent 
forces  of  the  cell- wall.  Reasoning  upon  the  general  physical 
law  that  "  like  effects  are  produced  by  similar  causes,"  we 
conclude  that,  if  in  any  case,  having  introduced  into  the 
circulation  of  the  healthy  subject  a  foreign  body,  we  observe 
the  phenomena  of  congestion  and  exudation,  with  stagnation 
of  the  current  of  the  blood,  identical  with  those  known  to  us 
as  the  phenomena  of  inflammation,  then  the  peculiar  inherent 
powers  of  the  cell-wall  must  have  been  affected  by  this 
foreign  body  in  precisely  the  same  way  (whatever  it  be)  as 
that  in  which  any  accidental  exciting  cause  of  inflammation 
affects  these  forces.  We  thus  discover  re-agents  which  act 
directly  upon  the  inherent  power  of  the  cell-wall,  and  we 
thus,  by  experiments  upon  the  healthy,  determine  precisely 
the  limits  and  direction  of  their  action.  This  knowledge  is 
rendered  possible  and  exact  by  the  science  of  Pathology, 
which  enables  us  to  trace  out  and  analyze  the  results  of 
intentionally  induced  abnormal  cell-action,  just  as  it  does 
those  of  accidental  disease. 

This  is  not  a  matter  of  mere  speculation.  It  is  well  known 
to  every  physician  that  almost  every  drug,  every  substance 
in  fact  which  is  not  a  simple  aliment,  has,  besides  any 
chemical  affinities  it  may  possess  for  some  of  the  secretions 
of  the  living  organs,  a  certain  peculiar  power  of  modifying 
the  functions  of  some  of  the  organs  of  the  body,  a  power 
which  is  inexplicable  and  is  recognized  only  by  its  results. 
Examples  of  this  power  of  drugs  are  found  in  that  of  Tartar 
emetic  to  produce  changes  which  result  in  congestion  and 
exudation,  of  Opium  to  produce  changes  which  result  in 
narcotism,  etc.  These,  which  are  known  as  the  specific 
properties  of  drugs,  are  evidently  the  properties  by  which 
they  modify  the  forces  of  the  cell-wall,  and  from  which  all 
observed  Pathological  (or  Pathogenetic)  and  Pathologico- 
anatomical  phenomena  result. 

And  it  is  manifest  that  the  specific  modifying  power  of 


112  RELATION   OF   PATHOLOGY 

each  drug  can  be  surely  ascertained,  as  an  absolute  property, 
by  testing  it  upon  the  healthy  living  organism.  And  it 
follows  as  clearly,  from  all  that  has  been  said,  that  the  appli- 
cation of  specific  drugs  which  have  a  direct  action  upon  the 
cell-wall  whose  inherent  forces  are  acting  abnormally  under 
the  influence  of  disease,  is  the  only  direct  and  radical  method 
of  curing  disease. 

The  task  of  finding  out  by  what  formula  the  specific 
action  of  drugs  upon  the  cell-forces  of  different  tissues 
should  be  brought  to  bear  upon  the  perverted  cell-forces 
in  any  given  case  of  disease,  comes  under  the  science  of 
Therapeutics  and  lies  beyond  our  present  province.  It  is 
the  problem  of  the  Therapeutic  Law. 

From  all  that  has  been  said,  the  Relations  of  Pathology 
and  Therapeutics  may  be  deduced  in  a  few  words. 

Physiology  and  Pathology  themselves  teach  us  that  the 
science  of  Pathology  can  in  no  sense  serve  as  a  basis  or 
foundation  of  the  science  of  Therapeutics.  They  show  us 
that  whereas  Pathology  is  the  science  of  disease  based  on 
a  theory  of  observed  morbid  processes,  Therapeutics,  when 
truly  regarded,  is  a  science  of  cure,  based  on  a  theory  of 
cure  and  resting  on  a  foundation  of  experiment.  Although 
not  the  basis  of  Therapeutics,  Pathology  must  yet  be  a 
most  important  instrument  in  the  practical  application  of  the 
science  of  Therapeutics. 

The  problem  in  the  art  of  medicine  being  to  apply  to  the 
abnormally  acting  cell-wall  that  remedial  agent  which  is 
capable  of  acting  directly  upon  it,  and  in  such  way  as  to 
restore  its  normal  action,  it  is  clearly  indispensable  that  the 
physician  be  able  to  trace  the  morbific  agent  through  all  its 
complex  resultant  phenomena  up  to  the  original  perversion 
of  cell-force,  from  which  the  whole  disorder  springs;  that 
he  be  able  to  analyze  secondary  and  tertiary  series  of 
phenomena  into  their  simple  elements.  And  in  this  work 
Pathology  is  the  instrument  of  which  he  avails  himself. 

I  cannot  refrain,  in  conclusion,  from  rendering  homage  to 


TO   THERAPEUTICS.  H* 

that  wonderful  prevision  of  genius  by  which,  in  an  age  when 
Pathology,  as  we  understand  it,  was  unknown,  Samuel  Hah- 
nemann  anticipated  all  that  we  have  said,  and  all  that  the 
most  advanced  writers  of  our  day  have  taught,  respecting 
the  scope  and  influence  of  Pathology  in  relation  to  Thera- 
peutics. 

The  symptoms  of  the  urinary  organs  in  connection  with 
the  discharge  of  morbid  urine  would  at  one  time  have  been 
regarded  as  the  proper  subject  of  treatment.  But  Pathology 
has  now  taught  us  to  trace  these  symptoms  back  to  the 
kidney,  and  beyond  the  kidney  to  the  blood,  and  beyond  the 
blood  to  the  nutrition  and  the  destruction  of  all  the  nitro- 
genized  tissues.  As  Dr.  Carpenter  remarks,  "When,  for 
example,  the  urine  presents  a  particular  sediment,  our 
inquiries  are  directed  not  so  much  to  the  kidney  itself,  as 
to  the  constitutional  state  which  causes  an  undue  amount  of 
the  substance  in  question  to  be  carried  off  by  the  urinary 
excretion,  or  which  prevents  it  from  being  (as  usual) 
dissolved  in  the  fluid."  To  confine  the  attention,  therefore, 
in  prescribing  for  a  given  case,  to  the  immediate  organ  the 
perversion  of  whose  functions  is  most  obviously  pointed  out 
by  the  prominent  symptoms,  is  to  disregard  the  clearest 
indications  of  Pathology.  We  must  analyze  these  obvious 
symptoms  and  must  include  their  remotest  elements  in  our 
indications.  Nay,  these  remotest  elements — the  constitutional 
disturbances,  for  instance,  of  which  Carpenter  speaks — are 
even  more  important  indications  for  treatment  than  the  more 
obvious  and  objective  symptoms.  But  how  can  we  analyze 
these  more  obvious  symptoms,  and  ascertain  those  "  consti- 
tutional disturbances  "  in  which  they  have  their  origin  ?  In 
no  other  way  than  by  a  study  of  the  functions  of  the  entire 
organism  —  in  what  way  and  to  what  extent  they  are  per- 
formed in  an  abnormal  manner.  But  this  brings  us  at  once 
to  that  rule  on  which  Hahnemann  so  strongly  insisted,  that 
the  entire  organism  of  the  patient  should  be  examined  in 
every  possible  way,  and  that  the  "totality  of  the  symp- 
9 


114   RELATION  OF  PATHOLOGY  TO  THERAPEUTICS.' 

toms"  should  be  made  the  basis  of  the  prescription  f  nay, 
that  the  constitutional,  general  symptoms  are  often  more 
conclusive  as  to  the  proper  treatment  than  the  more  obvious 
local  symptom.  The  grand  old  master  reached  at  a  single 
bound  the  same  conclusions  to  which  the  labors  of  a  half 
century  of  able  Pathologists  have  at  length,  with  infinite 
research,  brought  the  medical  profession. 

And  those  of  our  school  who  insist  upon  Pathology  as  a 
basis  of  Therapeutics,  who  look  upon  the  single  objective 
symptom  and  its  nearest  organic  origin  as  the  subject  for 
treatment,  and  who  deride  the  notion  of  prescribing  upon 
the  totality  of  the  symptoms,  and  claim  to  be  more  than 
mere  symptom-coverers,  in  that  they  discover  and  aim  to 
remove  the  cause  of  the  disease — these  colleagues  are  as 
false  in  their  Pathology,  according  to  the  highest  Old- School 
authority,  as  they  are  faithless  to  the  doctrines  and  impotent 
as  to  the  successes  of  the  founder  of  the  Homoeopathic 
School. 


PRIMARY  AND  SECONDARY  SYMPTOMS  OF 
DRUGS  AS  GUIDES  IN  DETERMINING  THE 
DOSE. 


As  preliminary  to  an  intelligible  discussion  of  this  question, 
we  must  briefly  define  primary  and  secondary  symptoms 
respectively,  and  state  how,  in  our  judgment,  the  discrimina- 
tion between  them  bears  upon  the  selection  of  the  remedy. 
And  this,  notwithstanding  these  questions  have  been  elabo- 
rately and  lucidly  discussed  by  other  members  of  this  bureau. 
For  it  will  not  have  escaped  the  reader's  observation  that 
these  terms  are  used  with  different  significations  by  different 
writers. 

Symptoms  may  be  called  primary  as  being  first  in  order 
of  occurrence,  in  comparison  with  others  which,  occurring  at 
a  later  period,  are,  with  reference  to  time,  secondary  to  them. 

Or,  symptoms  may  be  called  primary  as  being,  in  a  sense, 
the  exciting  cause  of  other  and  opposing  symptoms,  which 
are  then  secondary  to,  as  being  contingent  upon,  the  former. 

Or,  symptoms  may  be  styled  primary  as  being  of  greater 
importance  or  significance  than  others  called,  therefore, 
secondary. 

The  distinction,  then,  may  be  based  on  considerations  of 
time,  of  opposition  in  nature,  or  of  rank.  And  it  is  impor- 
tant not  to  confound  or  combine  these  ideas  in  our  discussions. 

Since  most  of  our  traditional  notions  on  this  subject 
originated  in  Hahnemann's  utterances  upon  it  throughout 
his  writings,  I  will  briefly  repeat  his  views  before  stating  my 
practical  conclusions. 

In  an  essay  entitled  Suggestions  for  Ascertaining  the 
Curative  Powers  of  Drugs,  published  1796  (S.  W.,  312), 


Il6    PRIMARY  AND  SECONDARY  SYMPTOMS  OF  DRUGS 

Hahnemann  says :  "  Most  medicines  have  more  than  one 
action ;  the  first  a  direct  action,  which  gradually  changes 
into  the  second  (which  I  call  the  indirect  secondary  action). 
The  latter  is  generally  a  state  exactly  the  opposite  of  the 
former.  In  this  way  most  vegetables  act.  But  few  medi- 
cines are  exceptions  to  this  rule,  e.g.,  metals  and  minerals." 
He  illustrates  what  he  means  by  the  secondary  action  in  the 
following  note :  "  Under  Opium,  for  example,  a  fearless 
elevation  of  spirit,  a  sensation  of  strength  and  high  courage, 
an  imaginative  gayety,  etc.,  are  part  of  the  direct  primary 
action  of  a  moderate  dose ;  but  after  eight  or  twelve  hours 
an  opposite  state  sets  in  —  the  indirect  secondary  action; 
there  ensue  relaxation,  dejection,  diffidence,  fear,  loss  of 
memory,  etc." 

In  the  preface  of  the  Fragmenta  de  Vir.  Med.  Pos.,  etc., 
1805,  Hahnemann  says:  "Simple  drugs  produce  in  the 
healthy  body  symptoms  peculiar  to  themselves,  but  not  all 
at  once,  nor  in  one  and  the  same  series,  nor  all  in  each 
experimenter;  but  to-day  perhaps  these,  to-morrow  those; 
this  first  one  in  Caius,  the  third  in  Titus,  but  so  that  on 
some  other  occasion  Titus  may  experience  what  Caius  felt 
yesterday. 

"  A  certain  drug  evokes  some  symptoms  earlier  and 
others  later,  which  are  somewhat  opposed  and  dissimilar  to 
each  other ;  indeed  may  be  diametrically  opposed.  I  call 
the  former  primary,  or  of  the  first  order,  and  the  latter 
secondary,  or  of  the  second  order. 

"For  each  individual  drug  has  a  peculiar  and  definite 
period  of  action  in  the  human  body,  longer  or  shorter,  and 
when  this  has  passed,  all  the  symptoms  produced  by  the 
drug  cease  together. 

"  Of  the  drugs,  therefore,  the  effects  of  which  pass  over  in 
a  brief  space  of  time,  the  primary  symptoms  appear  and 
disappear  within  a  few  hours.  After  these  the  secondary 
appear  and  as  quickly  disappear.  But  the  exact  hour  in 
which  any  symptom  may  be  wont  to  show  itself  cannot  be 


AS   GUIDES   IN  DETERMINING  THE  DOSE.  117 

positively  determined,  partly  because  of  the  diverse  nature 
of  men,  partly  because  of  different  doses.     *         *         * 

"  I  have  observed  some  drugs  the  course  of  whose  effects 
consisted  in  two,  three  or  more  paroxysms,  comprising  both 
kinds  of  symptoms,  both  the  primary  and  the  secondary  ; 
the  former,  indeed,  as  I  have  stated  in  general  terms, 
appeared  first  and  the  latter  second.  And,  sometimes,  it 
seems  to  me  I  have  seen  symptoms  of  a  kind  of  third  order. 
****** 

"  Under  the  action  of  moderate  or  small  doses,  the  symp- 
toms of  the  first  order  come  chiefly  to  view ;  less  frequently 
those  of  the  second  order.  I  have  chiefly  preserved  the 
former,  as  most  suitable  to  the  Medical  Art  and  most  worthy 
to  be  known." 

Finally  he  speaks  of  a  class  of  symptoms  which  he  de- 
nominates "  reliquias,"  generally  the  effects  of  very  large 
doses,  and  which  seem  to  indicate  or  depend  upon  more  or 
less  permanent  alterations  of  tissue,  including  the  symptoms 
of  the  "  agony"  in  fatal  cases. 

As  illustrating  these  views,  I  quote  remarks  prefixed  or 
appended  to  the  symptomatology  of  several  of  the  drugs 
mentioned  in  the  Fragmenta. 

In  a  note  to  Aconite,  Hahnemann  says :  "  Through  the 
whole  course  of  action  of  this  plant,  its  effects  of  the  first 
and  second  order  were  repeated  in  short  paroxysms,  two, 
three,  or  four  times  before  the  whole  effect  ceased  (eight  to 
sixteen  hours)."  And  he  describes  these  effects  as  follows  : 

"  Coldness  of  the  whole  body  and  dry  internal  heat  Chilli- 
ness. Sense  of  heat  first  in  the  hands,  then  in  the  whole  body, 
especially  in  the  thorax,  without  sensible  external  heat. 

"  Alternating  paroxysms  (during  the  third,  fourth,  and 
fifth  hours);  general  sense  of  heat,  with  red  cheeks  and 
headache,  worse  on  moving  the  eyeballs  upward  and  later- 
rally,  then  shivering  of  the  whole  body  with  red  cheeks  and 
hot  head ;  then  shivering  and  lachrymation  with  pressing 
headache  and  red  cheeks." 


Il8    PRIMARY  AND  SECONDARY  SYMPTOMS  OF  DRUGS 

In  a  note  to  Chamomilla,  Hahnemann  says :  "  The  course 
of  its  action  is  run  in  paroxysms  of  several  hours'  duration, 
comprising  symptoms  of  each  order,  free  spaces  or  remis- 
sions being  interjected,  so,  nevertheless,  that  in  the  earlier 
paroxysms,  the  symptoms  of  the  first  order,  in  the  later, 
those  of  the  second  order  predominate." 

In  a  note  to  Ignatia,  he  says :  "  Ignatia  is  wont  to  display 
the  curriculum  of  its  operation  in  several  paroxysms  com- 
prising both  orders  of  symptoms,  and  repeated  at  intervals 
of  several  hours ;"  and  concerning  the  mental  symptoms : 
"  Inconstancy,  impatience,  vacillation,  quarrelsomeness,  won- 
derful mutability  of  disposition,  now  prone  to  laughter,  now 
to  tears,"  he  says :  "These  mental  symptoms  are  wont  to  be 
repeated  at  intervals  of  three  or  four  hours." 

Hahnemann's  teachings  on  this  subject  in  the  Organon 
(in  which  all  the  editions  substantially  agree)  have  been  so 
fully  given  by  Dr.  C.  Wesselhceft  in  the  preceding  section  of 
the  report  of  this  bureau,  that  I  am  spared  the  necessity  of 
quoting  them. 

It  appears  that  Hahnemann,  in  the  Fragmenta  and  the 
Organon,  teaches  that  among  the  symptoms  of  a  drug, 
there  appear  series  which  are  opposed  to  each  other  in 
different  degrees  of  diversity,  from  being  "  somewhat 
opposed"  to  "  diametrically  opposite ;"  and  that,  of  these 
series,  that  which  occurs  first  in  order  of  time,  is  to  rank 
among  the  primary,  and  that  occurring  subsequently  among 
the  secondary  symptoms.  But  he  calls  attention  to  the  fact 
that  there  are  some  kinds  of  symptoms  in  every  proving,  to 
which  there  can  be  no  series  of  an  opposite  nature,  i.  e.,  to 
which  an  opposite  cannot  be  predicated ;  for,  he  says,  "  Our 
organism  always  bestirs  itself  to  set  up  in  opposition  to  this 
effect  [first  drug  action],  the  OPPOSITE  condition,  WHERE 
SUCH  A  CONDITION  CAN  EXIST."1 

In  his  definition  of  primary  and  secondary  symptoms, 
therefore,  Hahnemann  blended  the  elements  of  time  and  of 

1  Organon,  2d   and  3d  ed.,   §  74;  4th  ed.,  $63. 


AS   GUIDES   IN   DETERMINING  THE  DOSE.  119 

causation  or  nature  (viz.,  that  these  classes  were  opposed  in 
their  nature).  The  secondary  symptoms  were  not  an  inde- 
pendent series,  but  were  secondary  by  virtue  of  their  relation 
of  opposition  in  nature  to  a  series  of  preceding  symptoms. 
And  such  symptoms  as  did  not  in  their  nature  admit  of  an 
opposite  condition  (as,  for  example,  pain,  cutaneous  eruption, 
etc.)  could  not  be  called  primary,  because,  in  the  nature  of 
things,  they  could  not  be  followed  by  an  opposite  class  of 
symptoms.  Nor  could  they  be  called  secondary,  because,  in 
the  nature  of  things,  they  could  not  have  been  preceded  by 
an  opposite  series,  which  could  stand  to  them  in  the  relation 
of  primary  symptoms.  Hahnemann,  then,  appears  to  have 
recognized  in  the  pathogeneses  of  drugs,  symptoms  which 
being  opposed  ig  nature  could  be  arranged  into  series  of 
primary  and  secondary,  and  other  symptoms  not  susceptible 
of  such  arrangement. 

He  distinctly  tell  us1  that  the  primary  or  positive  symp- 
toms of  drugs  are  those  on  which  we  are  to  base  our 
prescriptions. 

These  statements  in  the  Organon,  as  quoted  by  Dr.  Wes- 
selhceft,  embrace  not  only  a  description  of  various  classes  of 
symptoms  as  observed  by  Hahnemann  in  drug-proving,  but 
also  a  theory  of  the  nature  and  genesis  of  these  various 
classes.  A  man's  observations  of  natural  phenomena,  if  he 
be  a  keen  and  accurate  observer,  as  Hahnemann  unquestion- 
ably was,  are  generally  correct.  His  theoretical  explanation 
of  them  is  pretty  sure  to  be  tinctured  with  the  philosophy  of 
the  period  in  which  he  wrote,  and  is  not  likely  to  be  accepted 
without  qualification  by  men  of  a  subsequent  period.  And, 
at  the  present  day,  few  would  accept  Hahnemann's  explana- 
tion of  the  genesis  of  primary  and  secondary  symptoms  as 
representing  respectively  a  state  of  passivity  followed  by  a 
state  of  intensified  activity  on  the  part  of  the  vital  force ; 
this  conception  of  a  vital  force,  in  the  sense  in  which  Hahne- 
mann used  the  term,  being  one  which,  itself,  has  been 

1  Organon,  2d  and  3d  ed.,  $  59 ;  4th  ed.,  $  152. 


120    PRIMARY  AND  SECONDARY  SYMPTOMS  OF  DRUGS 

discarded  by  most  physiologists.  But  the  rejection  of  the 
explanation  offered  by  Hahnemann  does  not  involve  the 
rejection  of  the  observations  to  which  he  attached  it. 

Among  the  symptoms  which  he  called  primary  (Erst 
wirkungen),  Hahnemann  recognized  the  occasional  occur- 
rence of  what  he  called  alternate  (Wechselwirkungen), 
opposed,  sometimes  contradictory  symptoms,  which,  never- 
theless, were  not  secondary.  He  does  not  tell  us  how  to 
recognize  these,  nor  how  to  distinguish  them  from  the 
secondary  symptoms.  But  he  does  give  us  instances  of 
what  he  regards  as  secondary  symptoms,  as  follows  :l  "  The 
gayety  which  follows  the  use  of  coffee  is  a  primary  symp- 
tom ;  the  subsequent  drowsiness  and  lassitude  are  secondary 
symptoms.  The  sleep  which  follows  Opium  is  a  primary 
and  the  subsequent  insomnia  a  secondary  symptom;  the 
purging  of  cathartics  is  a  primary  and  the  subsequent  con- 
stipation a  secondary  symptom.  The  constipation  of  Opium 
is  a  primary  and  the  subsequent  diarrhoea  a  secondary  symp- 
tom." And  consistently  with  Hahnemann's  instructions,  we 
should  not  expect  to  base  our  prescriptions  on  these  second- 
ary symptoms. 

But  when  we  examine  Hahnemann's  remarks  on  the  indi- 
vidual drugs  of  the  Materia  Medica  Pura,  we  find  devia- 
tions from  his  definitions  and  illustrations  as  given  in  the 
Organon.  In  the  preface  to  Belladonna  we  read:2  "There 
is  no  known  drug  of  long  action  which  expresses  itself  in  so 
manifold  (two  and  three  fold)  alternate  conditions  as  Bella- 
donna. Only  compare  symptom  15  with  16  and  this  with 
17,  56  with  58,  and  this  with  60,  61  and  114,  and  these  with 
113  and  152;  again,  62  with  63,  64,  and  these  with  70, 
and  62  with  72,  158  with  159,  and  this  with  160  and  165, 
and  this  with  163  ;  and  172  with  174  and  175,  and  these 
with  176.  Of  none  of  these  alternate  conditions  (Wechsel- 
wirkungen) can  it  be  said  that  they  are  beyond  the  primary 
action." 

1  Organon,  2d  and  3d  eds.,  $  76;       *  Materia  Medica  Pura,  1st  ed. 
4th  ed.,  $  65. 


AS  GUIDES   IN  DETERMINING  THE  DOSE.  121 

The  symptoms  thus  referred  to  describe  opposite  condi- 
tions as  follows : 

Contracted  pupils  and  dilated  pupils. 

Abdominal  pains  compelling  to  bend  backward  and  to  sit 
still, — to  move  forward  and  not  admitting  of  motion. 

Suppressed  stool  and  urine  and  involuntary  stool  and 
micturition,  and  constant  tenesmus. 

Sleeplessness  and  deep  slumber. 

Raging  delirium  and  wild  fear,  and  foolish  madness,  etc. 

It  is  evidently  Hahnemann's  meaning,  and  surely  experi- 
ence justifies  him,  that  Belladonna  may  be  given  (other 
symptoms  corresponding)  when  either  the  one  or  the  other 
(the  opposite)  of  these  conditions  is  present.  And  these 
opposites  belong  to  the  class  described  in  the  Organon  as 
secondary,  and  on  which  we  are  told,  we  are  not  to  base  our 
prescriptions. 

In  the  introduction  to  Nux  vomica  (Materia  Medica  Pura, 
1st  ed.)  Hahnemann  says :  "  The  symptoms  of  a  single  dose 
of  Nux  vomica  are  wont  to  recur  several  days  in  succession, 
at  the  same  time  of  day,  even  at  the  same  hour,  or  every 
other  day.  Hence  the  usefulness  of  this  drug  in  some  typical 
diseases  when  the  symptoms  otherwise  correspond.  Besides 
this  periodicity  of  the  symptoms,  and  besides  the  alternation 
of  heat  and  cold,  there  follow  also  upon  one  another,  here 
and  there  (as  is  the  case  also  with  other  drugs),  symptoms 
which  differ  very  much  from  one  another,  and  appear  to  be 
opposed  to  each  other,  although  they  all  belong  to  the  primary 
action  of  the  drug.  We  may  call  these  alternate  actions 
(Wechselwirkungen)."  And  among  the  symptoms  of  Nux 
vomica,  Hahnemann  calls  attention  to  232  and  233  "ano- 
rexia" as  contrasted  with  236-238,  "  great  appetite,"  and 
says  these  are  alternate  actions,  and  belong  to  the  primary 
symptoms,  and  are,  therefore,  to  be  used  as  bases  of  pre- 
scriptions. He  refers  also  to  369-374,  "  Constipation  with 
tenesmus,"  etc.;  and  to  357-359,  "Diarrhoea  with  desire 
and  tenesmus,"  etc.;  and  says,  in  a  note,  "Diarrhoea, 


122    PRIMARY  AND  SECONDARY  SYMPTOMS  OF  DRUGS 

constant,  abundant,  strictly  so  called,  is  not,  according  to 
my  observation,  to  be  expected  in  the  primary  action 
of  Nux  vomica;  and  that  which  here  appears  among  the 
symptoms  as  diarrhoea  is  partly  very  small,  mostly  mucous 
discharges  with  tenesmus  and  pain,"  etc.  Again,  in  a 
note  to  456,  he  says  :  "  Discharge  of  mucus  from  the  nose  is 
an  alternate  action  with  dry  obstructions  of  the  nose."  There 
is,  clearly,  a  discrepancy  between  Hahnemann's  general  prop- 
ositions in  the  Organon  and  his  practical  instructions  in  the 
Materia  Medica  Pura.  For  we  find  from  the  latter  that  Bel- 
ladonna, for  instance,  may  be  given  for  the  primary  symptom, 
"sopor,"  as  well  as  for  what  in  the  Organon  is  called  the 
secondary,  but  in  the  Materia  Medica  Pura  the  alternate  symp- 
tom "  sleeplessness,"  and  that  Nux  vomica  may  be  given  for 
the  primary  symptom  "  constipation,"  and  likewise  for  what 
is  called  in  the  Organon  the  secondary,  but  in  the  Materia 
Medica  Pura  the  alternate  symptom  "  diarrhoea." 

The  very  terms  primary  and  secondary,  as  thus  illustrated, 
seem  to  imply  a  succession  of  symptoms,  more  or  less  opposed 
in  character,  and  all  of  them  differing  from  the  equilibri- 
um of  function  which  we  recognize  as  health.  The  instances 
given,  and,  indeed,  the  only  possible  instances,  relate  to  func- 
tions of  which  a  "more"  or  "less,"  or  an  "opposite,"  may 
be  predicated ;  as,  for  example,  temperature,  sleep,  certain 
mental  conditions,  and  the  secretions  and  excretions  gener- 
ally. Thus  we  may  have"  an  unnaturally  prolonged  sleep  or 
wakefulness,  gayety,  or  despondency,  and  a  plus  or  minus  of 
sweat,  alvine  discharge,  urine,  etc.,  etc.  But  how  could  we 
have  an  opposite  condition  to  any  specified  pain  or  sub- 
jective sensation,  to  parenchymatous  deposit,  to  cutaneous 
eruption,  etc.,  etc.  ?  The  absence  of  these  phenomena  would 
be  pro  tanto  a  state  of  health  ;  it  would  not  be  an  opposed 
morbid  condition  or  sensation. 

The  possibility,  then,  of  classifying  symptoms  into  primary 
and  secondary  on  the  basis  of  the  relative  nature  of  the  symp- 
toms, is  not  co- extensive  with  symptomatology  ;  it  is  partial, 


AS   GUIDES   IN  DETERMINING  THE  DOSE.  123 

confined  to  a  moderate  number  of  conceivable  morbid  phe- 
nomena. 

Shall  we,  then,  in  the  second  place,  base  the  distinction  on 
the  element  of  time,  and  call  the  symptoms  which  first  occur 
primary,  and  those  which  come  later,  secondary?  Where 
then  shall  we  draw  the  line  ?  how  many  hours  or  days  shall 
we  allow  for  the  development  of  primary  symptoms?  In 
view  of  the  immense  differences  in  the  rapidity  with  which 
the  curriculum  of  action  of  different  drugs  is  run,  it  is  obvious 
that  a  special  rule  must  be  established  for  each  drug.  Nor  is 
this  the  only  difficulty.  The  results  of  different  doses  on  the 
same  provers,  and  of  different  doses  or  even  of  the  same  dose 
on  different  provers,  are  so  various  that,  ist,  as  Hahnemann 
intimates  in  the  preface  to  the  Fragmenta,  the  symptom 
which  appears  in  one  prover  to-day  will  not  appear  for  several 
days  in  another  prover ;  and,  2d,  a  very  small  dose  may  pro- 
duce only  one  series  of  symptoms ;  a  larger  dose  two  series 
of  opposed  symptoms ;  a  still  larger  dose  two  series  differ- 
ently opposed  ;  and  a  very  large  dose  again  only  one  series. 
This  point  has  been  so  well  illustrated  by  Prof.  Allen,  with 
whose  views  I  am  glad  to  express  my  entire  concurrence, 
that  I  need  not  dwell  upon  it,  but  may  content  myself  with 
two  illustrations  from  our  Materia  Medica. 

On  looking  over  the  register  of  symptoms  of  Argentum 
nitricum,1  we  find  reported  as  occurring  early  in  the  prov- 
ing, irritation  of  the  bladder  and  urethra  and  increased  fre- 
quency and  quantity  of  urine,  and  as  occurring  later  in  the 
proving,  diminution  in  frequency  of  micturition  and  in  the 
quantity  of  urine.  Surely  one  might  pronounce  the  former 
to  be  primary  and  the  latter  secondary  symptoms.  But  on 
examining  the  provers'  day-books  we  find  that  the  majority  of 
the  provers  (being  those  who  took  large  doses)  report  the 
former  and  not  the  latter  symptoms.  It  was  the  prover  who 
took  the  30th  who  reported  diminished  urine,  and  he  did  not 
report  any  increase  at  any  time. 

1  Oest.  Zeit.  I. 


124    PRIMARY  AND  SECONDARY  SYMPTOMS  OF  DRUGS 

These  symptoms,  therefore,  which  appear  in  the  register 
to  be  opposed,  and  properly  distinguishable  as  primary  and 
secondary,  did  not  bear  to  each  other  any  relation  of  appo- 
sition or  correlation,  as  they  might  have  done  had  they  oc- 
curred in  the  same  individual.  They  are  different,  unrelated, 
independent  effects  of  different  doses  in  different  individuals. 
And  let  me  suggest,  in  passing,  that  the  beautiful  pictures 
of  primary  and  secondary  effects  of  drugs  which  we  find  in 
works  of  Old -School  writers,  and  which  have  been  made  the 
basis  of  "  laws  of  the  dose  "  by  writers  of  our  own  school, 
are  composite  pictures  made  up  from  a  variety  of  observa- 
tions on  patients  and  from  cases  of  poisoning,  and  bear  no 
more  resemblance  to  a  pathogenesis  on  a  single  individual, 
than  the  composition  of  an  artist  which  has  the  mountains  of 
Ecuador  covered  with  the  forests  of  Oregon  and  decked  with 
the  flowers  of  Java  presents  to  a  faithful  landscape  from  nature. 

Most  of  the  provers  of  Tellurium  taking  the  3d  trit.  had, 
on  the  first  and  subsequent  days,  symptoms  of  the  general 
sensibility,  of  sweat,  of  the  skin,  of  the  bladder,  etc.,  etc. 
But  one  prover  who  took  the  4th  trit.  had  no  symptoms  at 
all  until  the  fourteenth  or  fifteenth  day,  when  cutaneous 
symptoms  affecting  the  ear  appeared  and  were  very  persist- 
ent and  troublesome.  Were  these  symptoms  secondary 
because  they  came  later  than  other  symptoms  in  other  prov- 
ers ?  And  secondary  to  what  ?  How  can  John's  lumbago 
be  secondary  to  James's  toothache  ?  But  during  the  second 
month  this  same  prover,  his  ear  symptoms  having  vanished, 
had  symptoms  referred  to  the  dorsal  spine.  Were  these 
secondary  to  the  ear  symptoms  because  they  came  later? 
Certainly  as  regards  time  they  were  secondary,  because  later. 
But  being  in  nature  wholly  unrelated,  neither  opposite  nor 
similar,  they  cannot  be  called  secondary  as  regards  nature 
nor  as  regards  rank  or  value.  Both  have  been  repeatedly 
verified  in  practice. 

Again,  we  are  told l  that  coldness,  a  condition  correspond- 
1  "The  Dose,"  by  E.  M.  Hale,  M.D.,  N.  A.  J.,  ix.  265. 


AS   GUIDES  IN  DETERMINING  THE  DOSE.  125 

ing  to  the  chilly  stage  of  fevers,  is  the  primary  effect  of 
Aconite,  and  that  a  state  corresponding  to  the  hot  stage  of 
fevers  is  the  secondary  effect  of  that  drug.  Let  us  hear 
Hahnemann.  In  the  introduction  to  Aconite1  he  says: 
"Aconite  is  one  of  a  few  drugs  whose  primary  action 
consists  in  several  alternating  conditions  of  chill  or  coldness 
and  heat."  And  now  let  us  study  the  day-books  of  the 
Austrian  provers  of  Aconite. 

Rothausl  took  tincture  of  Aconite  in  doses  regularly 
increasing  from  six  drops  daily  to  fifteen  drops  daily  for 
nine  days,  when,  feeling  powerful  effects,  he  ceased  taking  it 
and  noted  his  symptoms. 

From  the  second  to  the  eighth  day  inclusive,  he  had  the 
following  constantly  recurring  symptoms:  restlessness  at 
night ;  bad  dreams ;  unnatural  heat  of  body ;  rawness  and 
increased  secretion  in  the  larynx;  cough;  vertigo;  head- 
ache. On  the  ninth  day,  after  midnight,  severe  chill  in 
paroxysms  of  shivering,  starting  from  the  praecordia, 
lasting  two  hours,  followed  by  burning,  dry  heat,  with 
frequent,  feverish  pulse ;  and  this  followed  by  moderate 
sweat. 

For  the  next  six  days  he  had  various  troublesome  symp- 
toms affecting  the  chest  and  limbs,  and  on  the  sixteenth  day 
of  the  proving  he  had  again,  at  night,  a  febrile  paroxysm 
consisting  of  chill,  heat  and  sweat,  the  first  less  severe,  the 
last  more  abundant  than  on  the  ninth  day. 

On  the  seventeenth  day,  at  night,  a  similar  febrile  par- 
oxysm. Then  for  seven  days  symptoms  of  increasing 
severity  in  the  head  and  chest,  ending  with  haemoptysis  on 
the  nineteenth  day,  and  finally,  on  the  twenty-fourth  day,  a 
very  severe  and  well  marked  and  defined  neuralgic  head  and 
face  ache. 

How  can  the  ingenuity  of  the  most  ambitious  lawgiver 
find  a  pretext  for  dividing  the  symptoms  (especially  the 
febrile  symptoms)  of  this  excellent  proving  into  primary  and 

1  Mat.  Med.  Pura,  1st  ed. 


126    PRIMARY  AND  SECONDARY  SYMPTOMS  OF  DRUGS 

secondary  ?  A  febrile  paroxysm  occurred  on  the  ninth,  the 
sixteenth  and  the  seventeenth  days ;  before  it  and  after  it 
were  well-marked  symptoms  of  the  chest  and  extremities. 
Which  shall  be  primary  and  which  secondary  if  date  of 
occurrence  determine  the  question  ?  Which,  if  nature  or  if 
rank  determine  it  ? 

Certainly,  if  lateness  of  occurrence  stamp  a  symptom  as 
secondary,  then  the  neuralgic  head  and  face  ache,  the  very 
last  symptom  reported  by  Rothausl,  must  be  classed  as 
secondary.  Not  so  fast,  however !  In  the  proving  of 
Aconite  by  Zlatarovich  with  the  second  decimal,  which  he 
took  in  increasing  and  very  large  doses  for  seven  days  with- 
out effect,  the  very  first  symptom  was  a  violent  neuralgic 
head  and  face  ache,  almost  identical  with  that  described  by 
Rothausl  on  his  twenty-fourth  day. 

It  appears,  then,  that  Rothausl's  last  symptom  was  Zla- 
tarovich's  first.  If  the  time  of  occurrence  determines  the 
class,  we  must  rank  Rothausl's  headache  among  the  second- 
ary, and  Zlatarovich's  identical  headache  among  the  primary, 
and  thus  we  have  the  same  symptom  in  each  class,  which  is 
a  reductio  ad  absurdum. 

It  will  be  noticed  that  these  identical  symptoms,  produced 
at  different  times  in  different  provers  of  Aconite,  were  pro- 
duced by  different  doses.  The  opposite  symptoms  of  Argen- 
tum  nitricum  in  different  provers  resulted  from  different  doses. 

Prof.  T.  F.  Allen  has  shown  how  greatly  the  results  of 
different  doses  vary.  Dr.  Sharp  shows  that,  in  the  same 
prover,  Aconite  has  four  different  kinds  of  action  on  the 
heart,  as  shown  by  the  radial  pulse,  depending  'on  the  dose, 
and  that  in  only  two  of  these  is  one  series  of  symptoms 
followed  by  an  opposite  series. 

Hahnemann,  who,  it  must  be  remembered,  had  an 
immense  experience  as  a  drug-prover,  and  who  brought  to 
the  work  a  devotion  and  powers  of  observation  and  analysis 
rarely  equaled,  was  well  aware  of  the  fact  that  the  appear- 
ance of  apparently  contradictory  symptoms  in  a  proving  is 


AS   GUIDES   IN   DETERMINING  THE   DOSE.  127 

greatly  dependent  on  the  dose,  as  appears  from  §  66  of  the 
Organon  (4th  ed.),  in  which,  for  this  reason,  he  recommends 
the  use  of  small  doses  in  proving. 

Passing  for  a  moment  to  the  second  division  of  the  subject, 
the  value  of  primary  and  secondary  symptoms  as  guides  in 
selecting  the  remedy,  there  are  many  drugs  which,  having 
certain  constant  characteristic  symptoms,  have  also  series 
of  alternating  symptoms  relating  chiefly  to  the  secretions. 
Among  them  we  may  mention  Veratrum  album,  which  has 
(122-124)  "Thin  stool  passing  unnoticed  with  flatus.  Fre- 
quent liquid  stools.  Liquid  stools  unnoticed  with  flatus. 
Diarrhoea  of  acrid  faeces,  etc."  And  also  (127-139),  "  Con- 
stipation from  thickness  and  hardness  of  faeces.  A  desire 
and  compulsion  to  stool  in  the  upper  abdomen,  and  yet  no 
stool,  or  a  very  difficult  one,  as  if  from  inactivity  of  the  rectum, 
and  as  if  the  rectum  took  no  part  in  the  peristaltic  motion 
of  the  upper  intestines."  Also  Hahnemann  quotes  from 
Greding,  " Diarrhoea  with  copious  sweat"  and  "long-con- 
tinued constipation." 

The  efficacy  of  Veratrum  in  the  treatment  of  diarrhoea  of 
an  appropriate  character  is  universally  conceded  in  our 
school.  And  in  my  own  practice,  Veratrum  has  for  many 
years  been  a  frequently  used  and  highly  valued  remedy  for 
constipation  in  persons  of  all  ages,  but  especially  in  infants 
and  young  children,  in  whom  digestion  appearing  to  be  well 
performed,  the  evacuation  of  faeces  appears  nevertheless  to 
be  impossible  because  of  the  inertia  of  the  rectum — a  fact 
demonstrated  by  the  circumstance  that  a  healthy  stool  can 
be  procured  almost  at  will  by  irritation  of  the  rectum,  as  by 
the  common  practice  of  introducing  into  the  anus  a  piece  of 
soap  or  an  oiled  paper,  or  a  rubber  bougie.  We  have  here 
the  apparent  anomaly  of  the  same  remedy  equally  efficacious 
in  diarrhoea  and  constipation. 

Nux  vomica  furnishes  a  similar  example.  Its  efficacy  in 
certain  forms  of  constipation  as  well  as  of  dysenteric  diar- 
rhoea is  well  known. 


128     PRIMARY  AND  SECONDARY  SYMPTOMS  OF  DRUGS 

Let  us  now,  for  a  moment,  examine  a  little  more  closely 
the  nature  of  the  functions  affecting  which  the  alternate 
series  of  opposed  conditions,  which  have  been  called  primary 
and  secondary,  are  mostly  observed  in  drug-proving,  ist. 
They  are  such  as  in  the  nature  of  things  are  periodic,  and 
not  continuous ;  characterized  by  periods  of  repose  and 
activity,  and  susceptible  of  quantitative  and  qualitative 
correlative  interchange  among  themselves.  Thus  sleep  is 
periodic,  and  capable  of  being  supplemented  to  a  degree  by 
other  forms  of  repose  to  the  nervous  system.  The  intestinal 
canal,  the  genito- urinary  apparatus,  the  skin,  in  so  far  as 
secretion  and  excretion  are  concerned,  have  periods  of 
activity  and  repose ;  and  the  inactivity  of  one  may  be 
made  up  by  increased  activity  of  another.  And  thus 
the  function  of  any  one  of  these  apparatus  may  vary 
widely  at  different  times  without  a  condition  of  opposition 
being  established.  For  this  reason,  then,  the  mere  quantity 
of  one  of  the  excretions,  or  the  degree  in  which  any  one  of 
these  periodic  and  convertible  functions  is  performed,  does 
not  rank  first  among  the  indications  on  which  the  selection 
of  a  drug  is  to  be  based.  If  we  now  analyze  the  prescrip- 
tions of  Veratrum  and  Nux  vomica  referred  to,  we  shall 
find  certain  constant  phenomena  characterizing  both  the 
constipation  and  the  diarrhoea,  and  which  would  determine 
the  prescription  almost  without  reference  to  the  excretion. 

The  Veratrum  diarrhoea  is  uncontrolled  and  almost  unno- 
ticed by  the  patient,  liquid  faeces  escaping  with  the  flatus. 
Here  we  have  a  paretic  and  anaesthetic  state  of  the  rectum 
and  sphincter.  The  Veratrum  constipation  exists  solely 
because  the  rectum  does  not  perform  its  expulsive  function, 
and  is  not,  as  normally  it  should  be,  irritated  thereto  by  the 
presence  of  faeces.  Here  likewise  is  a  paretic  and  anaesthetic 
condition.  But  Veratrum  is  not  fully  indicated  in  either  case 
without  the  characteristic  general  symptoms :  general  depres- 
sion of  vitality ;  predominant  coldness  of  the  body ;  pallor 
and  cold  sweat  of  the  forehead,  or  of  the  whole  body,  on 


AS   GUIDES  IN  DETERMINING  THE  DOSE.  129 

slight  emotion  or  exertion,  as,  for  example,  on  having  a 
diarrhceic  stool,  or  making  the  ineffectual  effort  to  have  a 
stool,  if  constipated. 

Both  the  constipation  and  the  diarrhoea  of  Nux  vomica 
are  characterized  by  increased  but  uncoordinated  activity 
of  the  intestine,  evinced  by  tormina  and  tenesmus,  and  fre- 
quent insufficient  stools ;  so  that  the  condition  of  intestinal 
action  is  the  same,  whether  there  be,  as  in  one  case  a  minus, 
and  as  in  the  other,  a  plus  of  excretion ;  and,  indeed,  in  the 
Nux  vomica  patient  these  conditions  often  alternate.  These 
remarks  and  instances  will  sufficiently  illustrate  my  conclu- 
sions, viz. : 

That  the  appearance  or  non-appearance  of  opposed  series 
among  the  symptoms  of  a  drug  depends  chiefly,  if  not  alto- 
gether, upon  the  dose  in  which  the  drug  was  proved ;  and 
that  the  question  of  the  constant  and  necessary  appearance 
of  such  series  cannot  be  determined  until  experiments  with  a 
uniform  and  the  least  possible  dose  shall  have  been  made  by 
many  provers  with  the  same  drug,  and  in  the  case  of  many 
drugs,  and  therefore  that,  ist,  Although  in  our  Materia 
Medica,  as  it  now  exists,  pathogeneses  do  present  certain 
series  of  symptoms  more  or  less  opposed,  nevertheless 
(excluding  the  symptoms  of  the  agony  which  are  not  available 
in  practice),  inasmuch  as  these  series  of  symptoms  occur  in 
different  orders  in  different  provers  according  to  dose  or 
idiosyncrasy,  no  sound  practical  distinction  can  be  drawn 
between  them,  based  on  assumed  difference  of  nature,  by 
virtue  of  which  they  can  be  designated  respectively  as 
primary  and  secondary. 

2d:  That  symptoms,  apparently  opposed  (not  including 
those  of  the  agony),  occurring  in  a  drug-proving  are  equally 
available  as  guides  in  the  selection  of  remedies. 

Coming  now  to  the  special  subject  of  this  paper,  I  justify 
the  length  at  which  the  preliminary  subjects  have  been  dis- 
cussed by  the  suggestion  that,  if  I  have  shown  that  there  is 
no  basis  for  a  division  of  drug-symptoms  into  primary  and 
10 


130    PRIMARY  AND  SECONDARY  SYMPTOMS  OF  DRUGS 

secondary,  I  have  thereby  shown  the  impossibility  of  a  law 
of  dose  based  on  such  a  division.  Or,  if  admitting  that  in 
pathogeneses  there  do  appear  groups  of  symptoms  appar- 
ently opposed,  I  have  shown  that  these  refer  only  to  certain 
functions,  and  by  no  means  embrace,  or  could  be  made  to 
include,  the  symptoms  of  the  entire  organism.  I  have 
thereby  shown  that  an  alleged  law  of  dose  based  on  the 
existence  of  these  groups,  must  necessarily  be  partial,  and 
therefore  devoid  of  that  generality  of  application  to  the  entire 
pathogenesis  which  alone  would  justify  the  appellation 
"LAW;"  and  I  claim  to  have  shown  these  things. 

In  1844,  Dr.  C.  Hering  in  a  letter  to  the  German  Central 
Verein  in  session  at  Magdeburgh  (N.  Archiv.,  21,  3,  166) 
rejects  Hahnemann's  explanation  of  primary  and  secondary 
symptoms.  He  admits  that  there  are  in  every  proving 
primary  and  secondary  symptoms,  in  the  sense  that  some 
symptoms  appear  earlier  and  others  later  in  the  course  of  the 
proving,  but  affirms  that  although  these  may  appear  to  be 
opposed  to  each  other,  they  are  all  to  be  regarded  as  drug- 
symptoms,  and  as  such  are  to  be  made  the  basis  of  prescrip- 
tions. He  gives  instances  of  such  prescriptions  in  the  cases 
of  Conium,  Opium,  and  Mercury.  Indeed,  he  says  that  the 
longer-lasting,  more  permanent  and  more  opposed  to  the 
earlier  these  later  symptoms  are,  the  more  useful  are  they  in 
practice.  He  says  further,  that  "the  course  of  the  drug- 
disease  (in  proving)  must  correspond  with  that  of  the  disease 
to  be  treated."  Hering  further  states  that  "all  symptoms 
which  arise  in  provings  of  the  higher  potencies  are  similar  to 
the  later  effects  of  the  lower  or  so-called  stronger  doses,  and 
are  not  like  ti\e  first  effects  of  strong  doses."  He  adds  that 
the  great  characteristics  of  remedies  [as  we  have  seen  in  the 
cases  of  Nux  vomica,  Veratrum,  etc.]  accompany  both  the 
earlier  and  later  symptoms,  e.  g.y  the  burning  of  Arsenic. 

From  these  considerations,  Hering  deduces  the  following 
law  of  dose : 

"  Having  chosen  the  remedy  according  to  the  symptoms 
of  a  case  from  the  complete  correspondence  of  the  charac- 


AS   GUIDES   IN   DETERMINING  THE   DOSE.  131 

teristics  in  disease  and  drug,  we  have  only  to  consider 
whether  the  symptoms  of  the  case  generally  have  more 
resemblance  to  the  earlier  (primary)  symptoms  of  the  drug, 
and  then  we  give  the  lower  potencies ;  or  more  resemblance 
to  the  later  (secondary)  effects,  that  is,  to  the  symptoms 
produced  by  the  higher-potency  provings,  and  then  we  give 
the  higher." 

It  may  be  said  that  this  is  simply  saying :  Prescribe  doses 
analogous  to  those  which  produced,  in  the  proving,  the 
symptoms  presented  by  the  case  under  treatment.  But  it 
amounts  to  a  great  deal  more,  for  by  showing  that  the 
symptoms  produced  in  provings  by  small  doses  correspond 
with  the  later  effects  of  large  doses,  it  enables  us  to  infer  the 
effects  of  small  doses  in  cases  where  provings  have  been 
conducted  with  large  doses  only. 

In  1860,  Dr.  E.  M.  Hale  published  an  elaborate  article  in 
the  N.  A.  y.  of  H.,  vol.  ix.,  on  "The  Dose,"  in  which  he 
expresses  the  belief  that  he  has  discovered  the  long-desired 
law  by  which  "the  proper  dose  for  each  case  may  be 
selected  with  as  much  certainty  as  the  proper  remedy,"  as 
follows : 

"  In  any  case  of  disease  we  must  select  a  remedy  whose 
primary  and  secondary  symptoms  correspond  with  those  of 
the  malady  to  be  treated,"  and 

"  If  the  primary  symptoms  of  a  disease  are  present,  and 
we  are  combating  them  with  a  remedy  whose  primary 
symptoms  correspond,  we  must  make  the  dose  the  smallest 
compatible  with  reason;  and  if  we  are  treating  the 
secondary  symptoms  of  a  malady  with  a  remedy  whose 
secondary  symptoms  correspond,  we  must  use  as  large  a 
dose  as  we  can  with  safety." 

These  propositions  rest  on  the  assumption  that  all  drugs 
produce,  and  all  diseases  present,  two  series  of  symptoms, 
primary  and  secondary,  and  that  in  one  or  other  of  these 
classes  is  embraced  every  symptom  of  drug  or  disease.  I 
have  expressed  my  dissent  from  this  view,  and  given  reasons 
for  thinking  that  a  distinction  between  primary  and  second- 


132    PRIMARY  AND  SECONDARY  SYMPTOMS  OF  DRUGS 

ary  symptoms,  if  ever  justifiable,  is,  at  most,  applicable  to 
but  a  portion  of  the  symptoms  of  each  drug.  It  cannot,  if  I 
am  correct,  be  made  the  basis  of  a  general  law. 

Dr.  Hale  illustrates  his  meaning  by  referring  to  Aconite, 
the  primary  symptoms  of  which,  he  says,  "  correspond 
perfectly  with  the  chilly  stage  of  all  fevers"  while  the 
secondary  symptoms  of  Aconite  "  correspond  with  the  hot 
stage  of  fever."  He  therefore  recommends  a  small  dose  of  a 
dilution  of  Aconite  during  the  chilly  stage,  and  large  doses 
of  the  tincture  or  ist  decimal  during  the  hot  stage,  and 
relates  results  of  such  treatment,  which  seem  to  have 
satisfied  him,  but  would  hardly  have  satisfied  me. 

Again,  he  tells  us  that  the  primary  symptoms  of  a  group 
of  remedies,  of  which  Cinchona,  Ferrum,  Conium,  Nux 
vomica,  and  Ignatia  are  members,  are  such  as  to  denote 
that  these  drugs  first  "  increase  the  tone  and  strength  of  the 
muscular  or  nervous  system,  impart  vitality  and  vigor  to  the 
functions  of  the  vital  organs ; "  and  that  their  secondary  effects 
are  to  cause  "a  peculiar  atony,  a  condition  of  deficient  vitality, 
and  a  cachexia  of  a  more  or  less  obstinate  character."  And, 
stating  further,  that  an  outbreak  of  intermittent  fever  is 
always  preceded  by  "  an  era  of  good  feeling,"  a  condition 
of  exalted  muscular  and  nervous  tone  and  vigor,  he  regards 
this  as  the  primary  stage  of  that  disease,  to  be  treated,  when 
recognized,  therefore,  by  small  doses  of  Cinchona.  The 
outbreak  of  paroxysmal  fever  is  regarded  by  Hale  as 
belonging  to  the  secondary  series  of  symptoms,  and  therefore 
to  be  treated  by  as  large  doses  of  Cinchona  as  may  safely 
be  given. 

In  a  paper  presented  to  this  Institute  in  1874,  Dr.  Hale 
reiterates  these  views  in  substance  and  re-affirms  this  alleged 
"  law  of  dose."  He  illustrates  the  two  alleged  series  of 
symptoms  in  disease,  called  primary  and  secondary,  by  the 
instance  of  inflammation  of  the  urinary  passages,  in  which 
congestion  and  arrested  secretion  with  fever  and  pain  appear 
first,  and  are  succeeded  by  profuse  secretion  or  suppuration, 


AS   GUIDES  IN  DETERMINING  THE  DOSE.  133 

prostration  and  cessation  of  pain,  etc.  And  he  affirms  that 
the  group  of  cognate  drugs,  of  which  Cantharis  may  be  the 
representative,  presents  similar  series  of  primary  and 
secondary  symptoms. 

Considering,  first  of  all,  the  last  illustration,  it  is  true  that 
the  process  of  inflammation  consists  of  several  successive 
steps,  "accelerated  and  increased  circulation,  followed  *by 
retarded  and  diminished  circulation,  exudation  of  liquor 
sanguinis,  emigration  of  leucocytes  and  stasis,"  and  it  is  true 
that  the  earlier  steps  are  prior  to  the  later,  but  they  are 
equally  successive  and  necessary  steps  in  a  uniform  and 
definite  process,  and  nothing  justifies  the  drawing  a  line 
anywhere  in  the  process,  and  affirming  that  all  that  lies 
behind  the  line  belongs  to  a  different  and  opposite  series  to 
that  which  lies  in  front  of  it.  Nor  can  I  recognize  in  drug- 
provings  any  such  opposed  series.  Neither  Hahnemann's 
provings  of  Cinchona  and  Ferrum,  nor  Hahnemann's 
and  Harley's  proving  of  Conium,  nor  Hahnemann's  provings 
of  Nux  vomica  and  Ignatia  seem  to  me  to  support  the  alle- 
gations of  Dr.  Hale. 

Alluding  now  to  Hale's  remarks  upon  Aconite,  I  refer  to 
my  quotations  of  Hahnemann,  Rothausl,  Zlatarovich  and 
Sharp,  which  show  that  Aconite  does  not  produce  a  distinct 
chilly  stage  first,  followed  by  continued  heat,  but,  as  Hahne- 
mann says,  "  alternating  conditions  made  up  of  shiver- 
ing or  cold  and  heat,  and  recurring  frequently  or  at  longer 
intervals."  So  that  while  I  will  not  deny  that  Dr.  Hale  pre- 
scribed as  he  says  he  did,  and  with  the  results  which  he 
describes,  I  do  affirm  that  the  pathogenesis  of  Aconite  affords 
no  ground  for  the  theory  on  which  he  says  he  acted,  or 
which  he  deduced  from  his  action. 

And,  if  I  may  deviate  for  an  instant  from  the  subject 
strictly  under  discussion,  these  statements  about  Aconite  and 
its  application  suggest  the  fact  that  many  prescriptions  pro- 
fessedly homoeopathic  are  really  made  ex  usu  in  morbis,  and 
are  not  based  on  a  strict  individualization  of  the  case,  and  a 


134    PRIMARY  AND  SECONDARY  SYMPTOMS  OF  DRUGS 

selection  of  the  drug  whose  symptoms  correspond  to  it. 
Aconite,  having  early  acquired  a  reputation  as  a  remedy  in 
febrile  conditions,  is  too  often  given  in  routine  fashion,  "  in 
all  fevers  "  (to  use  Dr  Rale's  phrase),  and  therefore  in  many 
cases  in  which  the  symptoms  do  not  at  all  indicate  it.  For, 
as  even  Hahnemann  warned  us,  "  it  is  not  in  every  case 
presenting  febrile  symptoms  that  Aconite  is  homceopathically 
indicated ; "  and  therefore  it  cannot  truly  be  said  to  corre- 
spond to  the  "chilly"  or  any  other  "stage  of  all  fevers." 
Given  when  the  patient  is  quiet,  lies  still,  is  tranquil  in  mind 
and  hopeful  or  patient,  it  will  not  remove  the  symptoms  as  a 
homceopathically  selected  remedy  would  do.  Nor  is  it 
indicated  by  a  similarity  of  symptoms  in  any  save  a  small 
minority,  if  in  any,  of  the  intermittent,  remittent  or  con- 
tinued fevers  which  so  often  prevail  in  different  parts  of  our 
country,  nor  in  the  febrile  condition  which  persists  when 
parenchymatous  inflammation  is  established  in  any  important 
organ. 

It  was  my  purpose  to  follow  and  analyze  the  statements 
and  arguments  of  this  writer  on  this  important  subject,  but 
I  find  that  I  cannot  do  so.  His  premises  consist  of  citations 
from  allopathic  writers,  which  seem  to  me  to  be  statements 
based  on  observations  of  the  action  of  drugs  in  large  doses 
on  the  sick,  and  on  theoretical  deductions  from  these  obser- 
vations, and  which  certainly  bear  little  or  no  resemblance  to 
the  pathogeneses  of  the  Materia  Medica  Pura,  on  which  I 
have  been  wont  to  rely  for  a  knowledge  of  drug-effects,  but 
to  which  my  colleague  rarely  refers.  His  allusions  to  treat- 
ment seem  to  me  to  be  of  a  very  generic  character,  based 
on  assumptions  of  the  pathological  nature  of  the  disease  in 
question,  and  consisting  of  an  application  of  drugs  according 
to  a  vague  and  general  resemblance  of  assumed  pathological 
conditions.  In  all  of  this  I  fail  to  see  any  allusion  to,  or  any 
place  for,  the  strict  individualization  of  cases,  which  is  the 
very  essence  of  sound  homoeopathic  treatment.  In  studying 
these  papers,  in  fact,  I  hardly  realize  that  I  am  perusing  the 


AS  GUIDES  IN  DETERMINING  THE  DOSE.  135 

works  of  a  practical  homoeopathist,  according  to  my  concep- 
tion of  Hahnemann's  idea  of  homoeopathic  practice,  and  I 
perceive,  to  my  dismay,  that  I  do  not  stand  on  common 
ground  with  the  author  to  the  extent  necessary  to  make 
possible  a  further  discussion  of  his  treatment  of  the  question 
at  issue. 

I  must  content  myself,  therefore,  with  the  simple  state- 
ment that  my  own  observation  and  experience  do  not  enable 
me  to  corroborate  Dr.  Rale's  statement  of  the  "  Law  of  the 
Dose,"  based  on  the  distinction  of  primary  and  secondary 
symptoms.  Where  Aconite  has  been  truly  indicated  by  the 
symptoms  of  the  case,  I  have  seen  prompt  relief  follow  the 
administration  of  a  high  potency,  given  when  the  patient 
was  in  the  hot  stage,  and  likewise  when  in  the  chilly  stage ; 
and  in  both  the  effect  has  appeared  in  a  much  shorter  time 
than  Dr.  Hale's  remarks  would  lead  one  to  anticipate. 

In  the  treatment  both  of  constipation  and  of  dysenteric 
diarrhoea  by  Nux  vomica  in  cases  in  which  the  characteristics 
of  Nux  vomica  were  present,  the  higher  potencies  have  been 
equally  efficient,  leaving  nothing  to  be  desired,  and  the  same 
may  be  said  of  Veratrum  album  in  diarrhoea  and  in  consti- 
pation, when  the  characteristics  of  that  drug  were  present. 

It  may  be,  and  I  am  inclined  to  believe,  that  the  law  pro- 
posed by  Dr.  Hering  may  be  found  to  represent  the  facts ; 
but  for  its  demonstration  and  its  general  application  in 
practice,  we  need  a  much  more  complete  Materia  Medica 
than  has  yet  been  furnished  us. 

In  conclusion  of  this  branch  of  the  subject,  I  think  that  no 
law  for  the  determination  of  the  dose  can  be  deduced  from 
the  relation  of  opposition  or  contrariety  on  the  basis  of 
which  symptoms  have  been  divided  into  series  of  primary 
and  secondary. 


THE  DOSE  IN  DRUG-PROVING. 


The  symptoms  which  drugs  produce  upon  the  healthy 
organism  vary  according  to  the  dose.     They  may  be : 

1.  CHEMICAL — depending  on  the  chemical  affinity  which 
exists  between  the  drug  and  the  tissues  of  the  body,  and 
independent  of  vitality  ;  or, 

2.  MECHANICAL  (or  revolutionary),  consisting  chiefly  in 
violent  efforts  on  the  part  of  the  organism  to  eject  from  its 
cavities  the  offending  substance ;  or, 

3.  DYNAMIC,  contingent  upon  vitality  and  resulting  from 
the  relations  of  the  peculiar  properties  of  the  drug  to  the 
susceptibilities   of   the   living,    healthy    organism.       These 
dynamic  effects  may  be : 

A.  Generic — such  as  are  common  to  all  the  members  of 
a  certain  class  of  drugs  and  which  serve  to  distinguish  this 
class  from  others,  but  do  not  furnish  means  of  distinguishing 
between    different    individuals    of    the    same   class.      For 
example,  Arsenic  in  certain  doses  produces  vomiting  and 
diarrhoea,  with  cold  sweat  and  cramps  of  the  extremities. 
These  are  dynamic  effects  of  Arsenic  but  they  are  generic, 
since  other  members  of  the  class  to  which  Arsenic  belongs, 
viz. :    Cuprum,   Veratrum,   Tartar   emetic,    etc.,   in   certain 
doses,  produce  identical  symptoms ;  and  were  these  reme- 
dies proved  in  such  doses  alone,  it  would  be  impossible  to 
distinguish  the  pathogenesis  of  one  of  them  from  that  of  any 
of  the  others. 

B.  Specific — such  as  results  from  the  dynamic  action  of 
the  drug  and  are  peculiar  to  it.     They  serve  to  distinguish 
a  given  drug  from  all  others.     For  example,  Arsenic,  taken 


THE   DOSE   IN   DRUG-PROVING.  137 

in  different  doses  from  those  which  produce  the  generic 
dynamic  effects,  produces  vomiting  and  diarrhoea  or  ten- 
dencies thereto  ;  but  these  phenomena  are  accompanied  and 
characterized  by  conditions  quite  different  from  those  which 
accompany  the  similar  symptoms  of  Cuprum,  Veratrum,  etc., 
and  are  thus  distinguishable  from  the  effects  of  these  drugs. 

The  Specific-dynamic  symptoms  may  be  again  sub-divided 
into  Central  and  Peripheral. 

The  Central  symptoms  appear  speedily  after  the  drug  is 
taken,  are  generally  the  result  of  comparatively  large  doses 
and,  in  the  case  of  many  drugs,  are  confined  to  the  aliment- 
ary canal  and  to  the  organs  immediately  connected  with  it 

The  Peripheral  symptoms  appear  more  tardily,  are  gen- 
erally the  result  of  comparatively  small  doses,  taken  repeat- 
edly or  allowed  to  act  without  interruption  for  a  long  period, 
and  appear  in  the  bones,  skin,  glands,  etc.,  and  in  the 
coordinated  phenomena  of  life.  They  are  often  the  mani- 
festations of  a  dyscrasia  or  cachexy.  Doses  which  produce 
central  symptoms  do  not  generally  produce  the  peripheral 
(or  at  least  not  until  after  a  long  period  has  elapsed)  and 
vice  versa.  For  example,  Mercury,  in  certain  doses,  pro- 
duces well-marked  and  characteristic  action  upon  the  aliment- 
ary canal  and  its  appendages.  In  smaller  doses  it  produces, 
instead  of  these  effects,  a  series  of  symptoms  in  the  skin, 
bones,  glands,  etc. — the  Mercurial  cachexy.  The  former 
are  what  we  mean  by  central  specific  dynamic  symptoms. 
The  latter  are  the  peripheral  symptoms.  Arsenic,  again, 
furnishes,  according  to  the  dose,  examples  of  all  of  the  above 
varieties  of  symptoms.  In  certain  doses  it  develops 
chemical  and  revolutionary  effects.  In  smaller  doses,  as  we 
have  seen,  generic  dynamic ;  in  still  smaller  doses,  specific 
dynamic  symptoms  of  the  central  variety.  In  yet  smaller 
doses,  it  produces  peripheral  specific  symptoms,  which  are 
those  of  the  so-called  "gradual  poisoning;"  as  for  instance 
in  poisoning  by  exhalations  of  Arsenic  from  green  wall- 
paper, in  which  the  phenomena  of  vomiting  and  diarrhoea 


138  THE   DOSE   IN   DRUG-PROVING. 

or  the  central  specific  symptoms  do  not  appear,  but  instead 
of  these  we  have  evidence  of  a  distinct  cachexy,  in  the  skin 
and  glandular  symptoms,  marasmus,  etc. 

Such  are  the  varieties  of  symptoms  produced  by  corre- 
sponding varieties  in  the  dose.  It  is  hardly  necessary  to  say 
that  they  are  not  always  to  be  distinguished  with  precision ; 
but  the  facility  with  which  we  are  able  to  recognize  them  is 
in  proportion  to  the  completeness  of  our  proving. 

It  unquestionably  behooves  the  homoeopathic  physician  to 
have  an  exhaustive  knowledge  of  the  whole  sphere  of  action 
of  his  drugs ;  but,  as  a  prescriber,  he  'must  be  familiar  with 
the  varieties  and  subvarieties  of  dynamic  effects  which  we 
have  specified.  This  knowledge  is  to  be  attained  in  the  first 
place  only  by  drug-proving.  The  proving  of  drugs  must 
then  be  so  conducted  as  to  produce  in  the  greatest  possible 
completeness  and  clearness,  each  of  these  varieties  and  sub- 
varieties.  This,  as  has  been  shown,  is  to  be  accomplished  by 
a  skillful  selection  and  succession  of  doses.  It  is  not  so  simple 
and  easy  a  matter  as  it  might  at  first  view  appear  to  be  :  for, 

First :  The  doses  by  which  the  corresponding  varieties  of 
symptoms  are  produced,  differ  widely  in  different  drugs.  For 
example,  a  half  grain  of  crude  Nitrate  of  silver  or  of  Sul- 
phuric acid  produces  chemical  symptoms,  while  a  half  grain 
of  Lycopodium  or  of  Silicea  produces  probably  no  symptom 
at  all.  A  grain  of  Arsenic  produces  generic  dynamic  symp- 
toms, while  ten  grains  of  Natrum  muriaticum  may  be  inert. 
Forty  drops  of  Bryonia  tincture  may  excite  a  fair  show  of 
specific  dynamic  symptoms,  while  forty  drops  of  tincture  of 
Opium  will  produce  generic  dynamic  symptoms  or  full 
narcotism. 

Secondly :  The  susceptibility  of  different  provers  to  the 
same  drug  is  very  different,  and  the  degree  of  susceptibility 
which  each  prover  possesses  is  to  be  learned  only  by  exper- 
iment. For  example,  one  prover  will  take  five  hundred  drops 
of  Thuja  without  any  effect ;  another,  taking  twenty  drops, 
experiences  violent  specific  symptoms. 


THE  DOSE  IN   DRUG-PROVING.  139 

Thirdly  :  The  susceptibility  of  provers  to  different  prepa- 
rations of  the  same  drug  is  very  various  and  apparently  capri- 
cious. One  records  characteristic  specific  symptoms  from 
large  doses  of  the  crude  drug,  and  is  not  affected  by  smaller 
doses ;  another  is  acted  on  by  dilutions  and  not  by  any  quan- 
tity of  the  crude  substance. 

The  relative  power  of  a  drug  and  susceptibility  of  the 
prover  being  altogether  unknown  until  ascertained  by  direct 
experiment,  the  proving  of  a  new  drug  is  therefore  a  matter 
of  pure  experiment  in  every  particular,  and  it  might  at  first 
view  be  supposed  to  be  a  matter  of  indifference  in  what  man- 
ner or  with  what  doses  the  experiment  is  begun ;  which  vari- 
ety or  subvariety  of  symptoms  is  first  developed,  whether 
we  take  heroic  doses  and  develop  chemical  symptoms  or 
small  doses  and  produce  peripheral  dynamic  symptoms ;  since 
in  either  case  we  should  be  able  by  subsequent  experiments 
based  on  the  first,  to  develop  the  complementary  symptoms 
and  thus  complete  our  proving.  Experience  teaches,  however, 
that  this  supposition  is  not  sound,  and  for  the  following  rea* 
sons :  Drugs  vary  not  more  in  the  intensity  than  in  the  per- 
manence of  their  action  upon  the  organism.  Some  drugs 
appear  speedily  to  exhaust,  sometimes  by  a  single  large  dose, 
the  susceptibility  of  the  prover,  so  that  no  subsequent  doses, 
whether  large  or  small,  produce  any  effect.  Of  others  again, 
a  single  large  dose  develops  some  one  generic  or  central  spe- 
cific symptom,  and  along  with  it  induces  such  an  exalted  and 
distorted  susceptibility  that  every  subsequent  dose,  whether 
large  or  small,  evokes  straightway  that  one  symptom  or 
series  of  symptoms  and  none  other.  Thus  the  proving  is  in 
either  case  partial  and  incomplete— we  fail  to  get  those  symp- 
toms which  are  the  most  valuable  of  all  to  us,  as  being  those 
which  clearly  characterize  the  drug  and  enable  us  to  distin- 
guish it  from  all  other  drugs,  viz. :— the/m>//Wand  central 
specific  dynamic  symptoms.  To  illustrate  this  point,— it  is 
well  known  that  Mercury  given  in  such  doses  as  to  produce  cen- 
tral specific  symptoms,  induces  often  so  great  a  susceptibility 


140  THE   DOSE   IN  DRUG-PROVING. 

of  the  organism  to  the  action  of  this  drug  that  subsequent 
doses,  even  of  tolerably  high  dilutions,  provoke  straight- 
way a  series  of  central  symptoms.  The  same  is  true  of  Ar- 
senic. We  have  seen  a  case  in  which,  generic  and  specific 
symptoms  having  once  been  produced  by  massive  doses  of 
Tartar  emetic,  the  organism  remained  so  sensitive  to  the 
action  of  this  substance,  that  a  few  globules  of  the  thirtieth 
dilution  would  at  any  time  produce  vomiting  and  diarrhoea, 
with  cold  sweat  and  prostration.  It  may  be  said  that  these 
are  cases  of  very  unusually  great  susceptibility  to  the  action 
of  the  respective  drugs.  This  is  true,  but  it  is  precisely  such 
cases  of  great  susceptibility  that  are  of  exceeding  value  to 
us,  for  in  them,  by  judicious  experimentation,  we  could  get 
most  valuable  peripheral  symptoms,  unalloyed  by  generic  or 
by  revolutionary  effects. 

There  is  no  reason  to  believe,  on  the  other  hand,  that 
small  doses,  so  administered  as  to  produce  the  peripheral 
specific  symptoms,  modify  the  susceptibility  of  the  prover 
in  any  such  way  as  to  prevent  his  obtaining  by  subsequent 
larger  doses  the  central  specific,  the  generic  dynamic,  or 
even  the  chemical  and  mechanical  effects.  It  follows  from 
what  has  been  said,  that  to  obtain  an  exhaustive  proving  of 
a  drug,  we  should  begin  with  small  doses,  gradually  increas- 
ing the  quantity  until  unequivocal  symptoms  appear.  We 
shall  thus,  if  we  continue  our  experiments  a  suitable  length 
of  time^  obtain  peripheral  symptoms ;  and  these  small  doses 
will  not  have  so  influenced  the  system  as  to  prevent  our 
obtaining  by  subsequent  larger  doses  the  other  varieties  of 
effects.  Inasmuch  as,  in  the  nature  of  things,  the  peripheral 
symptoms,  representing,  as  they  do,  a  cachexy,  cannot  be 
speedily  produced,  a  considerable  space  of  time  should  be 
devoted  to  our  first  experiments  with  small  doses.  Finally, 
after  an  interval  of  non-medication,  larger  doses  should  be 
taken  until  we  have  exhausted  the  whole  dynamic  action  of 
the  drug,  and  even  obtained  a  fair  picture  of  its  chemical 
and  revolutionary  action,  although  this  may  in  a  measure  be 
gained  from  records  of  poisonings. 


THE  DOSE  IN   DRUG-PROVING.  141 

But,  in  this  relation,  what  are  the  "small  doses"  with 
which  we  are  to  begin  our  proving  ?  The  term  is  compara- 
tive. Are  they  drop  doses  of  the  tinctures,  or  are  they 
high  dilutions  ?  They  are  such  doses  as  have,  in  the  proving 
of  some  previous  drug,  shown  themselves  capable  of  produc- 
ing unequivocal  symptoms.  We  must  search  the  records  of 
provings,  therefore,  for  our  standard  initial  dose.  What 
this  is  at  present  we  shall  soon  see:  as  our  experience 
increases,  this  standard  may  from  time  to  time  be  altered. 

It  is  evident  that  the  method  of  conducting  a  proving  is  a 
matter  of  great  importance,  and  should  not  be  left  to  caprice 
or  accident.  The  completeness  of  our  Materia  Medica,  and 
consequently  our  ability  to  cure  disease,  depend  upon  our 
selection  of  a  happy  method.  This  important  subject  has 
received  the  attention  of  the  American  Institute  of  Homoeop- 
athy, to  which  the  Central  Bureau  of  Materia  Medica 
has  presented  a  report  on  Drug- Provings.  The  majority  of 
the  Bureau  repeat  Hahnemann's  directions  for  proving  as 
contained  in  the  Organon ;  and  as  regards  the  dose,  they 
recommend  "  the  prover  who  makes  use  of  potencies "  to 
make  a  trial  of  the  high  potencies  first,  and  afterward,  if 
necessary,  to  take  the  lower  dilutions  and  triturations,  or 
the  crude  substance  or  tincture,  if  satisfactory  results  are 
not  obtained  with  the  attenuations. 

This  recommendation  accords  with  our  deductions  and 
corresponds  with  the  spirit  of  Hahnemann's  directions. 
Hahnemann's  instructions  differed  at  different  periods  of  his 
life.  One  essential  idea,  however,  pervades  them  all — a 
small  dose  is  to  be  taken  at  first,  and  the  dose  is  to  be 
increased  until  unequivocal  symptoms  manifest  themselves. 
In  the  last  edition  of  the  Organon  he  adds,  as  the  result  of 
his  extensive  observation,  that  "The  most  recent  experience 
has  taught  that  medicinal  substances,  when  taken  in  the  crude 
state,  do  not  for  a  long  time  display  the  full  extent  of  their 
virtues,  as  they  do  when  taken  in  higher  developments. 
Thus  any  one,  even  of  those  medicines  whose  virtues  are 


142  THE  DOSE   IN  DRUG-PROVING. 

considered  weakest,  is  now  found  to  be  most  advantageously 
studied  if  four  to  six  globules  of  the  thirtieth  dilution  be 
taken  every  morning  for  several  days."  In  this  statement, 
Hahnemann  does  not  contradict  the  spirit  of  his  former 
directions,  for  he  adds,  "Should  the  effects  of  such  a  dose  be 
weak,  it  may  be  daily  increased."  He  further  ado's,  "The 
more  moderate  the  dose,  the  more  are  the  primitive  effects 
developed,  which  are  the  most  important  to  be  known." 
We  see  nothing  in  Hahnemann's  writings  which  shows  that 
he  ever  thought  of  restricting  the  dose  in  proving  to  the 
thirtieth  dilution,  as  some  have  stated;  he  simply  assures 
us  that  unless  provings  with  so  high  a  dilution  were  made, 
the  prover  would  fail  to  get  all  of  the  symptoms  which  the 
drug  is  capable  of  evolving. 

In  the  Minority  report  of  the  Central  Bureau,1  Dr. 
Hempel  differs  from  the  majority  in  so  far  as  the  proving 
with  dilutions  is  concerned.  He  would  propose  that  "  all 
such  provings  should  be  rejected  rather  than  encouraged ;" 
and  he  "  is  convinced  in  his  deepest  soul,  that  it  is  owing  to 
the  incorporation  of  such  provings  in  our  Materia  Medica 
that  all  the  confusion  and  uncertainties  with  which  it  is  now 
tainted,  are  presenting  immense  and  almost  insufferable 
difficulties  to  the  inexperienced  student  of  our  science." 
We  trust  that  it  is  unnecessary  to  say  that  in  commenting 
freely,  as  we  shall  do,  on  Dr.  Hempel's  report,  we  are 
actuated  by  no  unworthy  feeling  toward  our  colleague, 
whose  unceasing  and  very  arduous  labors  in  the  cause  of 
Homoeopathy  command  our  highest  respect,  and  deserve 
the  grateful  recognition  of  every  English  and  American 
Homoeopath.  We  speak  of  him  only  because,  by  his  report, 
lie  stands  forth  as  the  representative  of  certain  opinions, 
which  seem  to  us  unsound  and  unsupported  by  the  evidence 
on  which  they  are  supposed  to  rest. 

His  report  may  be  reduced  to  the  following  propositions : 
i.  Drugs    should  not   be    proved  with  attenuated  sub- 
stances. 

1  Am.  Horn,  Re-view,  vol.  i.,  p.  575. 


THE  DOSE  IN   DRUG-PROVING. 


143 


2.  The    middle    and    higher   potencies    do    not   produce 
reliable  symptoms,  unless  the  system  has  been  previously 
saturated  with  massive  doses  of  the  original  drug.     Corol- 
lary :  the  saturation  of  the  system  by   massive  doses  of  a 
drug  renders  it  susceptible  to  the  action  of  the  middle  and 
higher  potencies. 

3.  In   exceptional   cases   a   peculiar   idiosyncrasy    may 
enable  the  organism  to  develop  symptoms  from  the  higher 
potencies ;  but  "  it  is  unreliable  to  commence  the  proving 
with  these  potencies."     The  sequence  of  this  conclusion  is 
not  very  clear.     We  suppose  Dr.    Hempel  to   mean  that 
symptoms  developed,  where  an  idiosyncratic  susceptibility 
to  drug-action  exists,  are  not  so  reliable  as  those  developed 
where  there  is  no  idiosyncrasy. 

It  is  much  to  Dr.  Hempel's  credit  that  he  has  not  left 
these  propositions  to  stand  in  his  report  as  bare  unsupported 
assertions.  Recognizing  the  experimental  nature  of  the 
question,  he  has  referred  for  corroboration  of  his  views  to 
the  experience  of  those  who  have  made  our  provings,  and 
has  called  to  the  witness-stand  the  great  body  of  our  drug- 
provers  in  the  following  terms :  "All  the  splendid  provings 
of  the  original  provers  of  the  Materia  Medica,  and  of  the 
Austrian  Provers'  Union,  of  the  Provers'  Society  of  Prague, 
and  of  any  other  Provers'  Society,  whose  provings  are 
accepted  with  universal  acclaim  and  confidence,  have  been 
instituted  with  massive  doses  of  the  strongest  preparations  of 
the  drug ;  the  higher  and  middle  potencies  were  invariably 
tried  after  the  former."  If  this  statement  were  literally 
correct,  if,  indeed,  none  of  these  provers  ever  began  their 
provings  with  potencies,  then  they  are  incompetent  witnesses 
for  Dr.  Hempel's  purpose — they  are  incapable  of  testifying 
as  to  the  action  of  dilutions  when  not  preceded  by  massive 
doses,  since,  Dr.  Hempel  says,  they  never  tried  them.  If 
this  were  so,  then  the  second  proposition  of  Dr.  Hempel's 
report  would  rest  unsupported  save  by  the  one  witness 
whom,  we  neglected  to  say,  Dr.  Hempel  cites,  first  of  all,  in 


144  THE  DOSE  IN   DRUG-PROVING. 

these  words :  "  Dr.  Hempel  has  never  been  able  to  elicit 
any  reliable  symptoms  by  means  of  the  middle  or  higher 
potencies,  unless  the  organism  had  been  previously  saturated 
with  massive  doses  of  the  original  drug."  On  this  one 
point  of  negative  evidence,  then,  this  important  proposition 
stands — "Dr.  Hempel  has  never  been  able."  But  perhaps 
others  have  been  able.  Perhaps  the  very  witnesses  whom 
Dr.  Hempel  has  called  have  been  more  successful  than  he. 
We  will  cross-examine  them. 

First,  then,  we  call  upon  the  "  Original  Provers  of  the 
Materia  Medico,"  by  which  we  suppose  Dr.  Hempel  means 
Hahnemann's  "  Materia  Medica  Pura"  and  "  Chronische 
Krankheiten."  Of  these  provers,  the  "  Great  Original"  was 
Hahnemann  himself.  His  pupils  and  friends  adhered 
strictly  to  his  directions  and  method.  What  Hahnemann's 
opinion  was  as  to  the  propriety  of  commencing  a  proving 
with  small  doses  we  have  already  seen.  After  thirty-five 
years'  experience  in  drug-proving,  he  sums  up  his  observa- 
tions in  the  advice  to  begin  with  the  thirtieth  dilution. 
But  what  was  his  practice  ?  What  doses  did  he  actually 
take  ?  It  has  been  generally  supposed  that  he  did  not  as  a 
rule  record  the  doses  with  which  his  provings  were  made. 
Dr.  Hempel,  however,  seems  to  have  had  access  to  some 
sources  of  knowledge  on  the  subject  that  are  not  open  to  the 
general  reader,  for  he  tells  us  without  qualification,  that  "all 
the  splendid  provings  of  the  original  provers  of  the  Materia 
Medica  were  made  with  massive  doses  of  the  strongest  prepa- 
rations, etc."  Those  who  have  not  enjoyed  these  unusual 
means  of  information,  gather  from  a  few  observations,  scat- 
tered through  Hahnemann's  writings,  the  following  facts : 

Silver  was  proved  by  Hahnemann  in  the  first  trituration. 
The  Nitrate  of  Silver,  of  which  he  gives  a  few  symptoms,  in 
the  fifteenth  dilution.  Carbo  vegetabilis  was  proved  in  the 
third  trituration.  In  a  letter  in  the  Neues  Archiv.  (1813), 
he  directs  Stapf  to  prove  Helleborus  thus:  "Add  a  drop  of 
the  tincture  to  eight  ounces  of  water  and  one  drachm  of 


THE   D€)SE   IN   DRUG-PROVING.  145 

alcohol ;  shake  well,  and  take  an  ounce  every  hour  and  a 
half  or  two  hours  until  some  decided  effects  are  produced." 
And  camphor,  thus :  "  Dissolve  two  grains  in  a  drachm  of 
alcohol ;  shake  this  well  with  eight  ounces  of  water,  and  take 
in  from  four  to  six  doses  during  the  day." 

In  the  first  publication  of  the  proving  of  Natrum  muriat- 
icum  (1830),  Hahnemann  tells  us  that  a  great  part  at  least 
of  this  proving  was  made  with  the  thirtieth  dilution,  and  he 
adds,  that  "it  is  only  in  such  a  highly  potenized  form  that 
this  and  all  other  drugs  display  the  whole  of  their  power  to 
alter  the  condition  of  the  organism."  This  was  Hahnemann's 
conclusion  after  thirty  years  of  active  experience  in  drug- 
proving.  As  a  voucher  he  gives  us  the  proving  of  Natrum 
muriaticum,  the  value  of  which  is  attested  by  the  clinical 
experience  of  the  last  thirty  years,  and  confirmed  as  we 
shall  see  by  the  Austrian  re-proving.  In  the  same  volume  of 
the  Chronische  Krankheiten,  Hahnemann  published  the 
proving  of  Kali  carbonicum,  and  large  additions  to  the 
previously  published  provings  of  Carbo  vegetabilis,  Causti- 
cum,  Conium  and  Sulphur.  It  is  but  reasonable  to  con- 
clude that  the  symptoms  of  Kali  carbonicum,  and  many 
at  least  of  those  of  the  other  drugs  above  named,  were 
produced  by  the  thirtieth  dilution  as  well  as  those  of 
Natrum  muriaticum. 

In  view  of  these  facts,  it  is  hardly  correct  to  say,  as  Dr. 
Hempel  does,  that  "  all  the  provings  of  the  original  provers 
of  our  Materia  Medica  were  made  with  massive  doses  of  the 
strongest  preparations,  etc." 

Second,  we  call  upon  the  Austrian  Provers'  Union.  This 
society  conducted  in  the  years  1842  to  1848,  a  series  of 
re-provings  of  certain  of  the  drugs  proved  by  Hahnemann, 
in  the  hope  of  discovering  the  pathological  connection  of  the 
symptoms  which  in  Hahnemann's  scheme  are  disconnected. 
Conceiving  also  that  some  of  Hahnemann's  symptoms  were 
vague,  because  produced,  as  they  supposed,  by  small  doses, 
they  pushed  their  provings  with  massive  doses,  in  many 
11 


146  THE   DOSE   IN   DRUG-PROVING. 

cases  to  extreme  poisoning.  With  these  views  we  could 
hardly  expect  from  them  much  testimony,  either  positive  or 
negative,  on  the  subject  of  proving  with  potencies ;  but,  in 
that  which  they  do  furnish,  we  should  expect  them  to  be 
unfavorable  witnesses  for  our  views,  since  their  proclivities 
are  almost  uniformly  against  the  use  of  potencies  in  proving 
or  in  therapeutics.  Dr.  Hempel  says,  "  All  these  splendid 
provings,  etc.,  were  instituted  with  massive  doses ;  the 
middle  and  higher  potencies  were  invariably  tried  after  the 
former."  Let  us  examine  the  records. 

In  the  proving  of  Aconite,  sixteen  provers  made  in  all 
thirty-seven  experiments.  Six  of  these  were  made  with 
dilutions  from  the  first  to  the  twelfth  centesimal,  and 
symptoms  were  observed  in  all  but  one.  In  five  of  these 
cases,  large  doses  of  the  tincture  had  been  taken  before  the 
dilution.  In  one  case  the  prover  began  with  the  first  cen- 
tesimal dilution  and  got  symptoms. 

In  the  proving  of  Bryonia,  fourteen  provers  made  twenty- 
nine  experiments,  of  which  ten  were  with  dilutions  from  the 
first  decimal  to  the  203 d.  In  two  of  these,  the  provers 
began  with  the  dilutions,  viz.  :  with  the  tenth  and  the  thirti- 
eth, and  got  in  one  case  very  graphic  symptoms  ;  in  the 
other,  symptoms  unequivocal  though  less  numerous.  In  the 
cases  in  which  dilutions  were  used  after  massive  doses  of 
the  tincture  had  been  taken,  considerable  intervals  were 
allowed  to  elapse  after  the  last  symptoms  from  the  tincture- 
proving  disappeared  before  the  dilutions  were  taken,  e.  g., 
forty-one  days  before  the  203  d  dilution  was  taken,  and  yet 
this  dilution  appears  to  have  produced  decided  symptoms. 
It  is  true  that  the  propriety  of  ascribing  these  symptoms  to 
the  Bryonia  is  called  in  question  by  the  Editor  of  the 
Austrian  Journal,  but  with  scarcely  sufficient  grounds,  since  a 
subsequent  proving  with  the  203 d  dilution  evoked  them 
again.  Here,  then,  in  the  only  two  cases  in  which  dilutions 
were  taken  before  the  tincture,  symptoms  were  obtained 
(while  in  one  case  in  which  they  were  taken  after  the 


THE   DOSE   IN   DRUG-PROVING.  147 

tincture,  no  symptoms  were  observed,  shows  that  the  corollary 
to  proposition  No.  2  is  at  least  not  universally  true). 

In  the  proving  of  Silver  we  find  that  the  drug  was  taken 
by  one  prover  each  in  the  first,  second,  and  third  triturations, 
and  in  the  fourth,  fifth,  and  sixth  dilutions,  and  valuable 
symptoms  were  obtained  by  each.  The  Editor  calls  atten- 
tion to  the  great  correspondence  between  these  symptoms 
and  those  of  Hahnemann,  obtained,  as  we  know,  from  the 
first  trituration. 

In  the  proving  of  Nitrate  of  Silver,  the  Editor  remarks : 
"Between  the  experiments  a  sufficient  time  elapsed  to 
insure  against  the  effects  of  one  experiment  being  compli- 
cated by  those  of  a  preceding  one,  two  years  being  con- 
sumed in  the  proving."  The  proving  was  begun  with  the 
first  decimal  trituration,  and  subsequently  in  succession  the 
second,  sixth,  and  thirtieth  dilutions  were  used.  The  effect 
of  each  dose  was  allowed  to  expend  itself  before  a  new 
experiment  was  instituted ;  symptoms  clear  and  character- 
istic, and  covering  a  period  of  six  to  nine  days,  were  obtained 
from  a  single  dose  of  the  thirtieth  dilution.  Here,  it  is  true, 
the  dilutions  were  preceded  by  low  triturations,  yet  the 
Austrian  provers  were  of  opinion  that  in  these  cases  the 
lower  preparations  did  not  influence  the  susceptibility  of 
the  system  to  the  higher  potencies. 

In  proving  Kali  bichromicum,  in  only  two  cases  was  a 
dilution  higher  than  the  third  employed.  In  both  of  these  the 
twelfth  was  used  and  symptoms  were  obtained.  In  one,  that 
of  Dr.  Wachtl,  the  symptoms  from  a  single  dose  give  a  com- 
plete picture  of  the  subjective  and  objective  effects  of  this  drug 
in  the  pharynx  and  neighboring  organs.  In  neither  of  these 
cases  had  the  drug  been  previously  taken  in  massive  doses. 

In  the  proving  of  Colocynth,  fifteen  provers  made  twenty- 
five  experiments.  Ten  were  made  with  dilutions,  and  in 
nine,  symptoms  were  obtained.  In  three  of  these,  the  third 
dilution  was  used  and  no  other  preparation  of  Colocynth  had 
previously  been  taken. 


I48  THE   DOSE   IN    DRUG-PROVING. 

In  proving  Thuja,  twenty-three  provers  made  fifty-nine 
experiments.  Seventeen  were  made  with  dilutions,  and,  in 
thirteen,  unequivocal  symptoms  followed.  Nine  began  their 
provings  with  dilutions  and  got  symptoms.  Four  began 
their  provings  with  dilutions  and  got  no  symptoms.  But,  on 
the  other  hand,  seven  conducted  their  provings  with  massive 
doses  of  the  tincture  without  obtaining  any  unequivocal 
symptoms.  It  is  evident,  then,  that  negative  testimony  on 
this  subject  is  of  little  value. 

In  proving  Cochineal,  four  provers  began  their  experi- 
ments with  the  hundredth  dilution,  one  with  the  sixtieth 
and  one  with  the  thirtieth  dilution,  and  all  got  valuable 
symptoms.  One  prover,  on  the  other  hand,  began  with  the 
2OOth  dilution  and  gradually  descended,  getting  no  symptoms 
until  he  took  massive  doses. 

In  the  proving  of  Natrum  muriaticum,  thirty-nine  provers 
took  part.  Fourteen  began  with  dilutions  varying  from  the 
sixth  to  thirtieth, — the  majority  beginning  with  the  thirtieth, 
— twelve  obtained  symptoms  of  which  some  are  of  great 
value,  lasting  and  recurring  for  many  days  after  the  last  dose. 
Thus,  in  twelve  cases  out  of  thirty- nine,  dilutions  were  taken 
before  "  the  system  was  saturated  with  massive  doses  of  the 
strongest  preparations,  etc.,"  instead  of  dilutions  being  "  in- 
variably tried  after"  such  massive  doses. 

We  may  remark  that  in  every  case  in  which  we  ascribed 
symptoms  to  the  dilutions,  except  the  case  of  the  2O3d  of 
Bryonia,  they  have  been  so  admitted  by  the  Austrian  prov- 
ers themselves. 

In  conclusion,  we  may  observe  that  with  Natrum  muriati- 
cum the  record  of  the  Austrian  provings  closes.  In  his  con- 
cluding remarks  on  that  drug,  Dr.  Watzke  uses  the  following 
language:  "lam — alas!  —  I  say,  alas  !  for  I  would  much 
rather  have  upheld  the  larger  doses  which  accord  with  current 
views — I  am  compelled  to  declare  myself  for  the  higher 
dilutions.  The  physiological  experiments  made  with  Natrum 
muriaticum,  as  well  as  the  great  majority  of  the  clinical 


THE  DOSE   IN   DRUG-PROVING.  149 

results  attained  therewith,  speak  decisively  and  distinctly  for 
these  preparations.  Several  of  our  most  cautious  provers 
have  obtained  unquestionable  characteristic  Natrum  muriati- 
cum  symptoms  from  them."  It  is  remarkable  that  as  Hah- 
nemann  was  evidently  led  by  experience  to  recommend  that 
in  drug-provings  dilutions  should  be  used  as  well  as  crude 
preparations,  in  like  manner,  the  Austrian  prover  should,  as 
the  result  of  his  experience,  express  himself  as  above. 
Watzke  further  remarks  r1  "  I  am  very  far  from  regarding  a 
stormy  method  of  proving  as  the  only  proper  and  useful  one, 
and  I  recognize  the  conditions  of  an  all-sided  knowledge  of 
the  remedy,  in  the  free,  unrestrained  method  we  have 
adopted ;  experiments  being  made  with  large,  small,  and 
smallest  doses  according  to  the  disposition,  judgment  and 
good  pleasure  of  the  prover."  And  again,  in  reply  to  a 
critic,  "  My  friend  says,  '/have  proved  all  my  remedies  in 
strong  and  some  in  the  strongest  doses ;  with  many  I  have 
also  made  provings  with  the  higher,  even  with  the  thirtieth 
dilution'  —  Have  /then  done  otherwise  ?" 

In  a  recent  number  of  the  Allg.  Zeitung,  it  is  stated  that 
a  member  of  the  Old  Austrian  Provers'  Union  has  begun  to 
prove  Quassia  amara  with  the  thirtieth  dilution,  and  has 
obtained  valuable  symptoms.  Experto  crede. 

In  view  of  these  facts,  we  think  Dr.  Hempel  is  hardly  cor- 
rect in  stating  that  "  all  the  provings  of  the  Austrian  Provers' 
Union  were  made  with  massive  doses,  etc. —  the  middle  and 
higher  potencies  being  invariably  tried  after  the  massive 
doses." 

The  records  of  the  Austrian  Union  not  only  prove  that 
dilutions  may  evoke  trustworthy  symptoms  in  a  majority  of 
the  cases  in  which  they  are  employed,  but  they  also  give  us 
the  means  of  forming  a  judgment  on  the  propositions  which 
form  the  substance  of  Dr.  Hempel's  report. 

I.  "Drugs  should  not  be  proved  with  attenuations." — 
Mow,  since  it  has  been  shown  that  attenuations  produce 

Out.  Zeitschrift,  voL  hi.,  p.  64,  note. 


150  THE  DOSE  IN  DRUG-PROVING. 

reliable  and  valuable  symptoms,  we  submit  that  they  should 
be  used  and  for  these  reasons : 

(a.)  Because  attenuations  have  produced  symptoms  which 
have  not  also  been  produced  by  massive  doses,  and  which 
have  been  confirmed  by  clinical  experience.  In  the  proving 
of  Natrum  muriaticum,  the  only  distinct  picture  of  periodic 
fever  was  induced  in  Dr.  Wurmb  while  proving  the  thirtieth 
and  twenty-fifth  dilutions.  Dr.  Schreter,  proving  the  thirti- 
eth, got  symptoms  which  no  prover  with  massive  doses  pre- 
sents. In  the  proving  of  Thuja,  certain  symptoms  affecting 
the  vision  were  produced  in  Dr.  Huber  by  the  sixtieth  dilu- 
tion, and  in  Prof.  Zlatarovich  by  the  twelfth,  which  no  other 
provers  have  recorded.  In  the  proving  of  Colocynth,  the 
third  dilution  produced  symptoms  not  recorded  by  any 
prover  who  took  massive  doses,  and  yet  corroborated  by  a 
second  prover  with  the  third. 

(b.)  Because  some  provers  are  susceptible  to  the  action  of 
dilutions  or  small  doses,  and  not  to  that  of  massive  doses  of 
the  crude  substance.  For  instance,  Dr.  Wurmb  got  decided 
and  persistent  symptoms  from  dilutions  (thirtieth  to  sixth) 
of  Natrum  muriaticum.  From  lower  dilutions  and  from 
the  crude  substance,  even  in  half-ounce  doses  and  repeated 
frequently,  he  got  no  symptoms.  Was  this  because  his 
system  was  saturated  ?  We  think  not ;  for  on  recurring  to 
the  dilutions,  he  again  got  symptoms  as  at  first.  Now,  had 
the  provings  been  confined  to  the  crude  substance,  we 
should  not  have  Dr.  Wurmb's  proving  of  Natrum  muriati- 
cum, the  most  complete  and  reliable  single  experiment  that 
we  possess,  and  which  we  could  hardly  consent  to  give  up, 
notwithstanding  Dr.  Hempel's  opinion  that  "  potency-prov- 
ings  should  rather  be  rejected  than  encouraged."  The  same 
thing  is  observed  in  the  provings  of  Aconite,  Thuja  and 
Colocynth. 

2.  "  Potencies  do  not  produce  reliable  symptoms  unless 
the  system  has  been  previously  saturated  with  massive 
doses  of  the  crude  substance ;  and,  Corollary,  massive  doses 


THE   DOSE  IN   DRUG-PROVING.  15 1 

render  the  system  susceptible  to  the  action  of  smaller  quan- 
tities." 

We  have  shown  that  in  repeated  instances,  symptoms 
which  Hahnemann  and  the  Austrian  provers  regarded  as 
"reliable"  have  resulted  from  potencies  not  preceded  by 
massive  doses — symptoms  confirmed  by  other  provings  and 
by  clinical  experience.  On  what  grounds  does  Dr.  Hempel 
question  their  reliability  ? 

Again,  we  have  no  conclusive  evidence  that  massive  doses, 
as  a  rule,  render  the  system  more  sensitive  to  small  doses. 
In  some  cases  they  appear  to  do  so.  In  others  they  have 
the  opposite  effect.  In  the  records,  we  find  the  utmost 
variety  as  regards  the  susceptibility  of  provers  to  various 
doses.  Some,  like  Dr.  Wurmb,  are  susceptible  to  dilutions 
alone  of  a  given  drug,  others  to  massive  doses  alone.  Many 
obtain  symptoms  at  first  from  comparatively  small  doses  of 
the  crude  substance,  but  find  it  necessary  to  steadily  increase 
the  dose,  until  finally,  after  taking  in  some  cases  several 
hundred  drops  or  grains,  they  get  no  symptoms  at  all  from 
any  preparation.  This  looks  like  a  blunting  of  the  suscepti- 
bility rather  than  an  exaltation.  We  are  not  always  justi- 
fied in  assuming  that,  where  dilutions  were  taken  after 
massive  doses,  the  symptoms  were  due  to  the  massive  doses 
and  not  to  the  dilutions.  In  the  majority  of  these  cases  a 
sufficient  period  elapsed  between  the  experiments  to  prevent 
all  possibility  of  the  one  complicating  the  other.  In  a  few 
cases  no  such  period  elapsed,  and  in  these  it  may  be  that  the 
symptoms  ascribed  to  the  dilutions  were  really  due  to  the 
previous  massive  doses,  yet  even  in  these  cases  we  cannot 
be  certain  of  this ;  for  in  one  of  them,  that  of  Prof.  Zlataro- 
vich,  who,  after  taking  in  the  aggregate  several  thousand 
drops  of  the  Thuja-tincture,  changed  without  delay  to  the 
twelfth  dilution,  a  symptom  was  observed  which  had  not 
occurred  to  him  or  to  any  one  else  while  proving  the  tincture, 
but  only  to  Huber  while  taking  the  sixtieth. 

In  conclusion,  we  see  in  the  Austrian  records  more  reason 


152  THE   DOSE   IN   DRUG-PROVING. 

to  suppose  that  massive  doses,  as  a  rule,  blunt  than  that 
they  exalt  the  susceptibility,  although  in  some  cases  they 
unquestionably  have  the  latter  effect  As  these  cases 
cannot  be  recognized  in  advance,  it  is  clear  that  in  the  case 
of  an  individual  drug  or  prover,  nothing  positive  on  this 
head  can  be  assumed  as  a  basis  on  which  to  plan  a  proving. 

3.  It  is  said  that  "idiosyncrasy''  determines  the  action  of 
potencies,  and  that  provings  having  this  origin  are  not 
reliable. 

The  word  "  idiosyncrasy  "  is  used  in  two  senses.  Properly, 
it  signifies  an  abnormal  sensibility  to  drug-action ;  or  such  a 
relation  to  a  special  drug  as  that  the  drug  produces  in  the 
prover  symptoms  that  occur  to  no  other  prover,  and  which 
bear  no  analogy  at  all  to  the  symptoms  which  others  experi- 
ence. Such  symptoms  as  these  must  always  be  regarded  as 
suspicious  until  verified  by  clinical  experience.  Such  an 
idiosyncrasy  is  exemplified  by  persons  who  have  "  hay 
asthma,"  "  rose  catarrh,"  etc. 

But,  as  most  frequently  employed,  the  word  "  idiosyn- 
crasy" is  synonymous  with  "susceptibility,"  implying  an 
unusually  acute,  but  not  abnormal,  sensibility  to  the  action  of 
the  drug,  and  a  prover  who  shows  a  marked  susceptibility  to 
the  action  of  a  drug  is  said  to  have  an  idiosyncrasy  which 
favors  its  action.  This  susceptibility  is  similar  to  that  which 
individuals  exhibit  for  natural  diseases — some  being  prone 
to  one  kind  of  disease,  others  to  another,  just  as  one  prover 
is  especially  susceptible  to  Thuja,  another  to  Aconite.  Now, 
what  pathologist  would  think  of  objecting  to  a  case  of 
pneumonia  that  it  was  not  a  reliable  picture  of  the  disease, 
because  it  could  be  shown  that  the  patient  had  a  great 
susceptibility  to  the  disease,  and  took  it  on  the  slightest 
provocation  ?  A  certain  susceptibility  to  the  action  of  a 
drug  is  absolutely  necessary  to  a  good  proving.  Hahne- 
mann  speaks  of  it  in  his  Organon  as  a  necessary  condition. 
What  the  Austrian  provers  think  on  the  subject  may  be 
gathered  from  the  following  remarks  of  Watzke  (Dr. 


THE   DOSE   IN   DRUG-PROVING.  153 

Wurmb  proved  Thuja  five  times, — four  times  in  massive 
doses  and  once  in  dilutions ;  result  very  meager) :  "  We 
may  observe  that  the  proving  of  a  drug  is  not  so  easy  an 
affair  as  it  seems  to  be.  The  individuality  of  the  prover  as 
well  as  of  the  drug  plays  here  so  important  a  part,  that  a 
successful  proving  is  often  an  entirely  accidental  piece  of 
good  fortune  of  the  susceptible  prover,  while  the  boldest, 
but  unsusceptible  prover,  with  the  best  good-will  and  the 
greatest  devotion  may  obtain  only  a  scanty  and  one-sided 
result." 

This  susceptibility  may  be  to  the  drug  in  general  or  to 
particular  preparations  of  it.  Wurmb  was  acted  on  only  by 
dilutions  of  Natrfum  muriaticum.  Watzke  only  by  immense 
doses  of  the  crude  substance.  Watzke  was  sensitive  to  very 
small  doses  of  Thuja,  while  Wurmb  and  Reisinger  were 
almost  insensible  to  every  preparation  of  it.  Obviously,  then, 
a  prover's  susceptibility  varies  with  the  drug  and  with  the 
preparations,  and  can  be  learned  only  by  experiment  with 
all  preparations. 

From  the  general  tenor  of  Dr.  Hempel's  report,  one 
might  infer  that  while  the  middle  and  higher  potencies 
produce  symptoms  only  in  very  exceptional  cases,  massive 
doses  of  the  strongest  preparations  act  always.  The  records 
of  the  Austrian  provings  hardly  warrant  such  an  assumption. 
Of  the  thirty-one  experiments  made  with  tincture  of  Aconite, 
six  were  not  followed  by  any  trustworthy  symptoms.  Of 
the  thirty-six  made  with  large  doses  of  tincture  of  Thuja, 
seven  were  without  result.  Of  fourteen  made  with  large 
doses  of  crude  Colocynth,  one  was  without  result.  Of  the 
fifteen  provers  of  Byronia,  one  at  least  took  very  large 
doses  of  the  tincture  without  observing  any  symptoms. 
Several  who  took  large  doses  of  crude  Natrum  muriaticum 
were  insensible  to  its  action.  It  is  obvious,  then,  that  the 
development  of  symptoms  is  not  of  necessity  copious  and 
satisfactory  in  the  ratio  of  the  dose.  The  Austrian  records 
abound  in  editorial  remarks,  intimating  that  provers  have 


154  THE   DOSE   IN   DRUG-PROVING. 

defeated  their  object  by  taking  too  large  doses,  and  by 
repeating  the  dose  too  frequently. 

We  have  seen,  then,  that  potency-provings  may  be  trust- 
worthy and  that  they  are  indispensable  to  a  complete  and 
exhaustive  proving.  It  is  to  be  observed  that  even  the  few 
Austrian  potency-provings  which  we  have,  were  not,  gener- 
ally, conducted  in  such  a  way  as  to  demonstrate  the  full 
value  of  such  experiments.  In  very  many  cases,  only  a 
few  days  were  allowed  for  the  development  of  symptoms 
before  a  larger  dose  was  taken.  In  the  few  cases  in  which 
a  different  course  was  pursued,  as  in  Wurmb's  proving  of 
Natrum  muriaticum,  clear  and  persistent  and  most  valuable 
series  of  symptoms  were  obtained. 

In  order  to  obtain  a  perfect  proving,  the  prover  should 
ever  bear  in  mind  certain  fallacies  to  which  he  is  liable. 
These  fallacies  differ  according  to  the  dose  which  he  is 
employing;  they  are  equal  for  either  extreme  of  dose.  If 
he  use  the  higher  dilutions,  he  is  in  great  danger  of 
confounding  "imaginary"  symptoms  with  real  subjective 
drug  symptoms.  If  he  employ  massive  doses,  he  is  in  equal 
danger  of  including  in  his  record  chemical  and  mechanical 
symptoms.  Either  error  is  a  source  of  confusion  and 
uncertainty,  but  he  is  greatly  mistaken  who  thinks  to  avoid 
introducing  confusion  and  uncertainty  into  the  Materia 
Medica  by  simply  rejecting  potency-provings.  They  can  be 
avoided  only  by  the  constant  analysis  of  the  symptoms 
(whether  produced  with  potencies  or  with  large  doses), 
by  frequent  repetitions  of  the  provings  on  one's  self  and 
others,  and  by  clinical  verifications  of  the  symptoms.  The 
Austrian  records  give  an  example  of  the  latter  fallacy.  The 
symptoms  are  so  intermingled  with  chemical  and  revolu- 
tionary effects,  that  one  cannot  use  too  great  caution  in 
basing  a  prescription  upon  them, 

In  conclusion,  we  may  assume  the  following  points  to  be 
established  by  induction  and  by  direct  experience  : 


THE   DOSE   IN   DRUG-PROVING.  155 

In  order  to  obtain  an  exhaustive  proving : 

1.  We    must    prove  the  drug  both    in    dilutions   and  in 
massive  doses. 

2.  The    proving   should    be    commenced    with  dilutions; 
and  high    dilutions  should  be  employed    until    satisfactory 
evidence   is  obtained   that  the  prover   is  not  susceptible  to 
their  action.     We  thus  obtain  one  of  the  unknown  quantities 
of  our  problem,  viz.,  the  measure   of  the  susceptibility  of 
the  prover. 

3.  Where   a    keen    susceptibility   is  found    to    exist,    the 
greatest  care  must  be  exercised  to  avoid  blunting  or  pervert- 
ing it.     With  this  view,  repeated  experiments  should   be 
made  at  long  intervals,  with   high  potencies,  until   no  new 
varieties  of    symptoms    are    evoked.      Then,    after  a    long 
period   of  non-medication,    the   prover   should    take    lower 
potencies    and  then    small    doses    of    the    crude   substance 
repeated  at  intervals,  and  finally  after  another  long  period  of 
repose,  large  doses  of  crude  substance.      A  thorough  proving 
after  this  fashion  may  require  years  for  its  completion — but 
it  will  have  an  advantage  over  most  of  our  recent  provings, 
in  the  fact  that  it  will  be  thorough,  and  that   it  will   be  of 
permanent  and  certain  use  to  the  practitioner. 

4.  In  proving  with  dilutions,  as  well  as  with  massive  doses, 
a  long  period  of  time  should  be  occupied  in  testing  each 
preparation,  in  order  that  the  full  effect  may  be  seen  in  the 
production  of  dyscrasias,  etc. 

5.  The   greatest    care    should  be   exercised  in  verifying 
symptoms   by  repeated  experiments,  in  order  that  "  imagi- 
nary "    symptoms    on    the    one    hand    and    chemical    and 
mechanical  symptoms  on   the  other  may  be  excluded.     The 
fashion,  which  has  become  very  prevalent  of  late,  of  including 
in  the   pathogenesis  every    sensation  which    occurs    during 
the  proving,  without  distinction  or  verification — and  which 
may    be  called   the   Pre-Raphaelite   method    of  proving — 
cannot  be  too  strongly  rebuked. 


ALTERNATION  OF  REMEDIES.     No.   i. 


The  following  remarks  upon  the  interesting,  but,  in  our 
judgment,  unsound  paper  on  this  subject  by  Dr.  J.  R.  Coxe, 
jr.,  published  in  the  February  number  of  the  current  volume 
of  the  American  Homoeopathic  Review,1  may  serve  at  least, 
it  is  hoped,  to  call  attention  to  this  very  important  approach 
to  Polypharmacy  in  the  customary  method  of  prescribing, 
and,  perhaps,  to  stimulate  a  discussion  of  its  necessity  and 
propriety. 

In  admitting  that  the  alternation  of  remedies  is  incompat- 
ible with  the  theory  of  a  true  homoeopathic  prescription,  our 
colleague  has  granted  all  that  the  opponents  of  alternation 
could  reasonably  ask.  That  our  practice  has  not  yet  come 
up  to  our  theory,  and  that  we  are  not  yet  fully  possessed  of 
the  means  and  knowledge  to  bring  it  up  to  that  degree  of 
perfection,  and  that  therefore  some  prescribers  may  feel  con- 
strained sometimes  to  alternate  remedies,  as  it  were  zmder 
protest,  may  not  be  denied.  But  to  urge  that  because  our 
practice  lags  thus  behind  our  theory,  we  are  to  rest  satisfied 
with  it,  nay,  to  defend  it  and  to  conform  our  theory  to  it,  is  a 
position  that  would  be  fatal  to  all  progress,  and  which  we 
cannot  think  of  conceding.  .  Nor  is  the  appeal  to  experience 
in  the  sense  in  which  our  colleague  uses  it  valid.  He  "  has 
alternated  remedies  in  a  practice  of  twenty-five  years,  and 
his  practice  has  been  generally  successful."  We  do  not 
doubt  this.  But  we  believe  his  respected  father  practiced 
allopathy  for  a  much  longer  period,  and  was  a  successful 
practitioner ;  would  this  fact  be  a  valid  argument  in  favor 
of  allopathy  ? 

1  Vol.  iiL,  1863. 


ALTERNATION   OF   REMEDIES.      NO.    I.  157 

Alternation  and  succession  of  remedies  are  not  generally 
understood  to  be  identical  processes.  By  alternation,  we 
think,  practitioners  generally  understand  the  prescription,  at 
one  and  the  same  time,  of  two  or  more  remedies  to  follow 
each  other  at  short  intervals,  the  symptoms  of  these  remedies 
taken  altogether  being  thought  to  cover  the  symptoms  of 
the  case  more  completely  than  those  of  either  remedy  alone 
would  do.  The  prescription  is  the  result  of  one  single 
examination  of  the  patient  and  of  one  single  comparison  of 
the  symptoms  with  the  Materia  Medica. 

But  when  a  succession  of  remedies  is  given,  in  either  an 
acute  or  a  chronic  disease,  the  understanding  is,  that  the 
first  remedy,  having  been  carefully  selected,  is  allowed  to 
exhaust  its  action  alone,  and  then  a  collection  of  the 
symptoms  the  patient  then  presents  is  made,  and  the  case  is 
prescribed  for  afresh,  almost  as  if  it  were  a  new  case ;  and 
this  process  is  repeated,  each  new  prescription  being  the 
subject  of  a  special  study,  until  the  case  is  cured.  Such  a 
process  is  equivalent  to  prescribing  for  a  number  of  new  and 
independent  cases,  and  it  is  evidently  not  incompatible  with 
the  theory  of  a  true  homoeopathic  prescription. 

The  very  thoughtful  article  by  Dr.  Payne,  to  which  refer- 
ence is  made  by  Dr.  Coxe,  contains  nothing  incompatible 
with  these  views.  He  instances  cases  in  which  a  remedy 
which  had  covered  all  the  symptoms  acts  well  for  a  time, 
then  ceases  to  act,  and  leaves  the  case  still  uncured.  He 
advises  then  a  fresh  study  of  the  case,  and  especially  a  study 
of  the  previous  history  of  the  patient,  and  the  prescription 
of  a  suitable  antipsoric  or  antisyphilitic  —  in  fact,  a  strictly 
homoeopathic  prescription  de  novo.  Now,  in  many  such 
cases,  acute  though  they  appeared  at  the  outset,  if  the  pre- 
scriber  had  studied  thus  carefully  at  the  very  beginning,  not 
only  the  present  symptoms,  but  also  the  previous  history  of 
the  patient,  a  single  antipsoric  prescribed  at  first  might  have 
sufficed  for  the  case.  For  although  chronic  diseases  may  be 
incurable  except  by  an  antipsoric,  antisyphilitic  or  anti- 


158  ALTERNATION   OF   REMEDIES.      NO.    I. 

sycotic,  yet  these  remedies  may  also  be  required  in  the  very 
beginning  of  diseases  that  appear  to  be  most  acute.  I  can 
certainly  testify,  from  repeated  observation,  to  the  efficacy 
of  Sulphur30  in  most  violent  puerperal  peritonitis,  that 
remedy  being  all  that  was  required  to  bring  the  cases  to  a 
speedy  and  favorable  issue.  This  calls  to  mind  Hahne- 
mann's  admonition — Organon,  §  257.  * 
The  physician  "  should  never  lose  sight  of  this  great  truth, 
that  of  all  known  remedies  there  is  but  one  that  merits  a 
preference  before  all  others,  viz. :  that  whose  symptoms 
bear  the  closest  resemblance  to  the  totality  of  those  which 
characterize  the  malady." 

Be  this  as  it  may,  Dr.  Payne's  advice  clearly  contemplates 
a  new  study  of  the  case  for  every  new  prescription,  and,  if 
this  plan  be  pursued,  the  treatment  will  be  strictly  homoe- 
opathic, even  though  a  dozen  remedies  were  required  in 
succession  before  the  case  is  cured. 

Alternation,  however,  as  generally  understood  and  prac- 
ticed, does  not  contemplate  this  new  study  of  the  case  before 
a  second  remedy  is  administered,  or  before  every  change  of 
remedies ;  and  herein  it  fails  to  come  up  to  the  requirements 
of  a  true  homoeopathic  prescription.  And  this  is  the  kernel 
of  the  whole  controversy. 

Suppose  a  case  of  pleurisy.  Bryonia  covers  all  the  symp- 
toms. The  patient  improves  for  a  time  and  then  ceases  to 
improve.  The  case  is  studied  anew.  Some  symptoms  are 
found  to  have  vanished ;  some  new  ones  have  appeared. 
The  physician  studies  the  previous  history  of  the  patient 
more  closely ;  he  may  or  may  not  conclude  that  there  is  a 
psoric  taint.  At  all  evejits  he  perceives  that  Sulphur 
corresponds  to  the  symptoms  better  than  any  other  remedy. 
He  prescribes  Sulphur,  therefore,  just  as  though  this  were  a 
new  case  that  had  just  come  under  his  treatment.  This  is  an 
instance  of  succession  of  remedies.  But  each  prescription  is  a 
strictly  homoeopathic  one,  and  in  every  respect  commendable. 

Suppose  another  case.     A  patient   has   acute   tonsilitis. 


ALTERNATION    OF   REMEDIES.      NO.    I. 


159 


The  physician  collects  his  symptoms  and  prescribes  "  Bella- 
donna, to  be  followed  in  four  hours  by  Mercurius,  and  that 
again  in  four  hours  by  Belladonna,  and  so  on."  These  two 
steady  nags,  so  familiar  to  all,  in  this  relation,  are  sometimes 
enlivened  by  the  company  of  Aconite  and  Coffea  (pro  re 
nata)  where  the  prescriber  has  no  scruples  about  driving 
"four  in  hand." 

This  is  an  example  of  alternation  of  remedies,  and  is 
objectionable  on  the  following  grounds:  Suppose  the  first 
dose  of  Belladonna  to  have  been  a  judicious  prescription, 
and  to  have  had  an  effect  How  can  the  prescriber  know 
beforehand  that  this  effect  will  be  just  such  as  to  cause  the 
totality  of  the  symptoms  at  the  end  of  four  hours  to  corre- 
spond exactly  to  Mercurius,  and,  what  would  be  still  more 
wonderful,  how  can  he  foresee  that  the  effect  of  the  Mer- 
curius will  be  just  such  as  to  cause  Belladonna  to  be  better 
indicated  than  any  other  remedy  at  the  end  of  another 
period  of  four  hours  ?  .The  second  remedy  (a  fortiori  a 
third  or  fourth ! )  in  such  cases  must  always  be  prescribed 
without  a  preliminary  study  of  the  actual  condition  of 
the  patient  as  modified  by  the  action  of  the  first  remedy. 
It  cannot,  therefore,  be  an  exact  homoeopathic  prescrip- 
tion. 

Hahnemann  has  expressed  himself  fully  on  this  subject  in 
the  Organon 1  as  follows : 

Sec.  272.  "  In  no  instance  is  it  requisite  to  employ  more 
than  one  simple  medicine  at  a  time."  : 

Sec.  169.  "  It  may  easily  occur,  on  examining  a  disease 
for  the  first  time,  and  also  on  selecting  for  the  first  time  the 
remedy  that  is  to  combat  it,  that  the  totality  of  the  symp- 

1  Fourth  edition,  British  translation.  given  both  remedies  at  the  same  time, 

2  Experiments  have  been  made  by  or  nearly  so ;  but  I  earnestly  caution 
some  Homceopathists  in  cases  where,  all    my    adherents    against    such    a 
imagining  that  one  part  of  the  symp-  hazardous  practice,  which  never  will 
toms  of  a  disease  required  one  remedy,  be  necessary,  though,   in    some    in- 
and  that  another  remedy  was   more  stances,  it  may  appear  serviceable." 
suitable  to  the  other  part,  they  hare 


160  ALTERNATION   OF   REMEDIES.      NO.    I. 

toms  of  the  disease  is  found  not  to  be  sufficiently  covered  by 
the  morbific  symptoms  of  a  single  medicine,  and  that  two 
remedies  dispute  the  preference  as  to  eligibility  in  the 
present  instance,  the  one  being  homoeopathic  to  one  part  of 
the  disease,  and  the  other  still  more  so  to  another.  It  is, 
then,  by  no  means  advisable  after  using  the  preferable  of  the 
two  remedies,  to  take  the  other  without  examination, 
because  the  medicine  given  as  the  inferior  of  the  two,  under 
the  change  of  circumstances,  may  not  be  proper  for  the 
remaining  symptoms ;  in  which  case,  it  follows,  that  a  suit- 
able homoeopathic  remedy  for  the  new  set  of  symptoms 
should  be  selected  in  its  stead." 

Sec.  167.  "In  short,  if  the  application  of  an  imperfect 
homoeopathic  remedy  used,  in  the  first  instance,  cause  any 
accessory  symptoms  of  some  importance,  the  action  of  the 
first  dose  is  not  allowed  to  exhaust  itself  in  acute  diseases; 
the  altered  state  of  the  patient  is  then  to  be  examined  and 
the  remainder  of  the  primitive  symptoms  to  be  joined  to 
those  which  have  been  recently  discovered,  to  form  of  the 
whole  a  new  image  of  the  disease." 

Sec.  1 68.  "A  new  remedy  that  is  analogous  may  then  be 
easily  discovered  among  the  medicines  that  are  known,  a 
single  application  of  which  will  suffice,  if  not  to  destroy  the 
disease  entirely,  at  least  to  facilitate  the  cure  in  a  great 
degree.  If  this  new  remedy  is  not  sufficient  to  restore  the 
health  completely,  then  examine  what  yet  remains  of  the 
diseased  state  and  select  the  homoeopathic  remedy  that  is 
most  suitable  to  the  new  image  that  results  from  it.  In  this 
manner,  the  physician  must  continue  until  he  attains  his 
object  —  that  is  to  say,  until  he  has  fully  restored  the  health 
of  the  patient." 

The  name  and  practice  of  Hahnemann,  Boenninghausen 
and  Hering  have  been  adduced  in  support  of  alternation. 
Hahnemann's  views  on  the  subject  we  have  already  quoted 
from  the  Organon.  The  case  to  which  Dr.  Coxe  refers,  as 
cured  by  Hahnemann  by  "  the  alternate  use  of  Bryonia  tinct- 


ALTERNATION   OF  REMEDIES.      NO.    I.  l6l 

ure  and  Pulsatilla,"  has  escaped  our  notice,  and  we  should 
esteem  it  a  favor  if  Dr.  Coxe  would  inform  us  whereabouts 
in  homoeopathic  literature  it  is  recorded. 

Hahnemann  published  very  few  cases.  In  vol.  ii.  of  the 
Materia  Medico,  Pura,  third  edition,  1838,  he  relates  two 
cases,  one  of  which  was  cured  by  a  single  dose  of  Bryonia 
tincture,  and  the  other  by  a  single  dose  of  Pulsatilla.  May 
Dr.  Coxe  have,  possibly,  referred  inaccurately  to  these  cases 
and,  by  a  fault  of  memory,  blended  them  ? 

It  is  often  stated,  however,  that  Hahnemann  used  Bryonia 
and  Rhus  toxicodendron  alternately  in  his  very  successful 
treatment  of  the  typhus  or  hospital  fever  which  prevailed 
so  extensively  in  northern  Germany,  in  1813-14,  after  the 
French  invasion.  A  reference  to  his  article  on  the  "  Treat- 
ment of  the  Typhus  or  Hospital  Fever  at  present  prevailing," 
originally  published  in  the  Allgem.  Anzeig.  der  Deutschen, 
number  six,  1814,  and  translated  by  Dr.  Dudgeon  among 
"  Hahnemann's  Lesser  Writings,"  1  will  show  how  erroneous 
this  statement  is. 

He  says,  "  This  fever  has  two  principal  stages,"  of  which 
he  gives  the  distinguishing  symptoms ;  the  first  stage  being 
characterized  by  "pains  and  consciousness"  the  second 
stage  by  "delirium  and  mania." 

"  In  the  first  stage,"  he  continues,  "  two  vegetable  sub- 
stances are  of  use  and  generally  quite  remove  the  disease  at 
the  commencement — the  Bryonia  alba  and  the  Rhus  tox- 
icodendron." 

He  proceeds  to  give  the  special  indications  for  each  of 
these  remedies.  "If  the  patient  complains  of  dizziness, 
shooting  (or  jerking-tearing)  pains  in  the  head,  throat,  chest, 
or  abdomen,  etc. „  which  are  felt  particularly  on  moving  the 
part — in  addition  to  the  other  symptoms,  the  haemorrhages, 
the  vomiting,  the  heat,  the  thirst,  the  nocturnal  restlessness, 
etc.,  we  give  a  single  drop  of  Bryonia12.  Improvement  takes 
place  in  the  course  of  four  and  twenty  hours,  and  as  long  as 

1  P.  631  et  seq.,  American  edition. 

12 


1 62  ALTERNATION   OF   REMEDIES.      NO.    I. 

the  improvement  goes  on,  we  give  him  no  other  medicine,  nor 
even  repeat  the  same  dose. 

"  If  now  the  amendment  produced  by  the  single  dose  of 
Bryonia  goes  off  in  the  course  of  two,  three  or  four  days,  that 
is  to  say,  if  the  patient  then  complains  of  shooting  pains  in 
one  or  other  parts  of  the  body  whilst  the  part  is  at  rest;  if  the 
prostration  and  anorexia  are  greater,  if  there  is  harassing 
cough  or  such  a  debility  of  certain  parts  as  to  threaten 
paralysis,  we  give  a  single  drop  of  Rhus  toxicodendron12  and 
no  more  nor  any  other  medicine  so  long  as  the  improve- 
ment is  manifest  and  continued.  *  *  Or,  if  the  symptoms 
I  have  just  described  occur  at  the  very  commencement  of 
the  attack,  we  give  at  its  very  commencement  a  drop  of 
Rhus  toxicodendron12."  *  *  *  * 

"  The  whole  disease  will  generally  be  removed  by  a  single 
dose  of  the  first  or  of  the  second  medicine  (according  as  the  one 
or  the  other  is  indicated,  without  the  addition  of  any  other). 

"  If,  notwithstanding,  the  disease  should  pass  into  the 
'second  stage'  of  delirium  and  mania,  then  Hyoscyamus 
niger  meets  all  the  indications  of  the  case." 

These  detailed  directions  for  the  treatment  of  an.  epidemic 
disease  give  a  perfect  picture  of  a  true  homoeopathic  treat- 
ment They  state,  in  substance,  that  the  generic  symptoms 
of  the  disease  are  always  accompanied  in  the  commencement 
by  one  or  the  other  of  two  groups  of  characteristic  symp- 
toms. Accordingly,  as  one  or  the  other  of  these  groups  is 
present,  Bryonia  or  Rhus  is  to  be  given.  When  the  conse- 
quent amelioration  ceases,  then  the  case  is  to  be  examined 
anew,  and.  according  to  the  characteristics  then  found  to 
present  themselves,  a  new  remedy  is  to  be  selected,  and  thus 
the  practitioner  is  to  go  on  until  the  case  is  cured.  But 
alternation  is  nowhere  advised  or  allowed. 

Hahnemann's  brief  and  very  general  hints  relating  to  the 
treatment  of  croup  are  of  the  same  general  character.  In 
the  introduction  to  Spongia,1  he  says:  "  Homoeopathy  has 

1  Materia  Medica  Pura,  vol.  vi.,  second  edition,  Dresden,  p.  199. 


ALTERNATION  OF  REMEDIES.      NO.    I.  163 

found,  in  symptom  145  and  in  other  symptoms,  the  most 
remarkable  applicability  of  Spongia  to  that  terrible  acute 
disease  —  membranous  croup — provided,  however,  the  local 
inflammation  has  first  been  diminished  or  subdued  by  a  very 
small  dose  of  Aconite.  The  additional  use  of  a  small  dose 
of  Hepar  sulphuris  will  rarely  be  found  necessary."  Nothing 
is  here  said  or  in  any  way  intimated  concerning  alternation. 

In  giving  general  directions  beforehand  for  the  treatment 
of  this  disease,  which  usually  presents  a  very  uniform  group 
of  symptoms,  he  shows  that  the  symptoms,  while  the  local 
inflammation  is  still  raging,  call  for  a  very  small  dose  of 
Aconite ;  that  when  this  has  acted,  it  will  generally  be  found 
that  the  local  inflammation  is  subdued,  leaving  a  group  of 
symptoms  which  correspond  best  to  the  symptoms  of 
Spongia ;  that  sometimes  there  may  be  such  a  modification 
as  to  call  instead  or  subsequently  for  Hepar  sulphuris. 

When  a  physician  has  it  in  his  power  to  visit  his  cases 
frequently,  and  to  watch  their  course,  he  has  no  excuse  for 
deviating  from  the  methods  of  a  true  homoeopathic  prescrip- 
tion. If  it  prove  necessary  to  give  a  succession  of  remedies, 
he  is  bound  to  make  each  successive  prescription  the  subject 
of  a  special  study,  both  of  the  symptoms  of  the  patient  and 
of  the  provings  in  the  Materia  Medica,  and  to  select  on  each 
occasion  the  remedy  which  corresponds  best  to  the  symp- 
toms of  the  case. 

But  where,  as  sometimes  happens,  the  physician  is  unable 
to  see  the  case  at  all,  or  where  he  is  giving  general  direc- 
tions for  the  treatment  of  a  case  which  it  is  supposed  may, 
at  some  future  time,  occur,  this  accuracy  is  impossible.  His 
duty  is  then  to  describe  to  his  client  the  symptoms  which 
will  probably  be  present  in  each  stage  of  the  disease,  if  it 
appear  in  the  ordinary  form  and  follow  the  ordinary  course ; 
to  point  out  the  indications  for  the  appropriate  remedy  in 
each  stage ;  and  to  instruct  his  client  to  give  only  one  medi- 
cine at  a  time  at  each  stage,  and  never  to  repeat  the  dose, 
or  to  give  any  other  remedy  so  long  as  amelioration  is 


1 64  ALTERNATION   OF   REMEDIES.      NO.    I. 

manifest.  This  is  the  best  the  physician  can  do  when 
treating  disease  under  the  disadvantage  of  never  seeing  the 
patient.  This  is  the  method  adopted  by  Hahnemann  with 
reference  to  hospital  typhus.  It  is  the  method  of  Dr. 
Boenninghausen  in  treating  croup. 

It  is  well  known  that  Dr.  Bcenninghausen  does  not  visit 
his  cases,  but  prescribes  chiefly  in  his  offices.  He  knows 
that  the  first  symptoms  of  croup  are  almost  uniformly  com- 
bined with  a  local  inflammation  which,  along  with  all  the 
other  symptoms,  forms  a  group  to  which  Aconite  corresponds 
better  than  any  other  remedy.  His  first  powder,  therefore, 
is  Aconite.  And  his  instructions  are  explicit.  The  second 
powder  is  never  to  be  given  until  the  amelioration,  conse- 
quent on  the  first,  shall  have  ceased,  and  so  with  the  remain- 
ing powders.  The  recipients  of  "  croup  powders "  are 
especially  and  carefully  instructed  under  what  circumstances 
alone  it  is  proper  to  give  any  or  all  of  the  subsequent 
powders.  This  is  as  near  an  approach  to  a  new  study  for 
each  change  of  remedy  as  is  possible  when  the  physician 
does  not  see  the  patient. 

It  does  not  really  amount  in  most  cases  even  to  a  succes- 
sion, much  less  an  alternation  of  remedies,  for  in  a  large 
majority  of  cases  the  Aconite  alone  cures  the  patient. 

That  Dr.  Bcenninghausen  does  not  regard  this  method  as 
an  "alternation  of  remedies"  is  shown  in  vol.  ii.,  p.  £61,  of 
the  American  Homoeopathic  Review. 

Indeed,  in  theory  and  in  practice  Dr.  Bcenninghausen  is  as 
decidedly  opposed  to  alternation  as  we  have  shown  that 
Hahnemann  was. 

We  believe  we  could  say  that  Dr.  Hering's  views  are 
similar  to  those  we  have  expressed,  but  we  prefer  to  await  a 
statement  from  his  own  vigorous  pen  of  those  arguments, 
both  theoretical  and  practical,  which  none  could  give  so 
well  as  he. 

In  conclusion,  we  hope  it  is  hardly  necessary  to  add,  that 
inasmuch  as  offensive  language  and  odious  epithets  lend  no 


ALTERNATION  OF  REMEDIES.      NO.    I.  l6§ 

strength  to  argument  nor  sweetness  to  persuasion,  we 
entirely  agree  with  our  colleague  in  his  closing  paragraph. 
Nay !  for  that  very  reason,  he  will  allow  us  to  say,  we  could 
almost  wish  his  own  expressions  had  been  a  very  little  less 
emphatic. 


ALTERNATION  OF  REMEDIES.     No.  2. 


When,  in  the  February  and  April  numbers  of  this  Review,2 
vol.  iii.,  1863,  we  published  Dr.  J.  R.  Coxe's  article  on 
Alternation,  and  our  own  modest  objections  to  what  we 
regarded  as  unsound  argument  and  inaccurate  statement  on 
the  part  of  Dr.  Coxe,  we  had  no  idea  that  we  were  enter- 
ing upon  the  discussion  of  a  question,  about  the  terms  of 
which  there  could  be  any  chance  for  a  misunderstanding. 
Subsequent  publications,  from  various  quarters,  have  shown 
that  all  practitioners  do  not  understand  the  same  thing  by 
the  word  alternation,  as  applied  to  the  mode  of  prescribing 
homoeopathic  remedies.  We  think  we  shall  be  able  to  show 
that  the  practice  which  some  writers  defend,  under  the  name 
of  alternation,  is  not  properly  called  by  that  name.  But, 
before  entering  upon  the  subject  itself,  we  desire  to  make, 
once  for  all,  two  statements  of  general  principles  by  which 
we  are  governed  not  only  in  the  treatment  of  this  question 
but  of  all  questions  that  concern  the  practice  of  medicine ; 
premising  that  we  utterly  disclaim  any  disposition  to  dogma- 
tize or  to  speak  as  with  authority  on  any  question  of  medical 
practice.  If  the  earnestness  of  conviction  should  betray  us 
into  too  positive  warmth  of  language,  this  is  our  misfort- 
une ;  and  none  can  disapprove  it  more  decidedly  than  we 
regret  it. 

i.  The  business  of  the  physician  is  to  cure  his  patient; 
this  is  the  great  practical  object  of  his  labor.  We  believe 
that  nature  is  not  always  restricted  to  a  single  path — and 
that  while  some  cases  are  so  severe  that  there  is  but  one 

^American  Homoeopathic  Review,  1865.  *Ibid,  1863. 


ALTERNATION    OF  REMEDIES.      NO.    2.  167 

way  in  which  it  is  possible  to  cure  them,  there  are  often 
several  ways  in  which  it  may  be  possible  to  effect  the  cure 
of  some  other  case  ;  each  way  having  more  or  less  of  incon- 
venience attaching  to  it  and  of  detriment  resulting  from  it,  in 
proportion  as  it  differs,  more  or  less  widely,  from  the  best 
way.  Thus,  we  believe  that  Allopathy,  with  her  heroic 
antiphlogistic*,  her  revulsives  (borrowed  from  the  "  circum- 
locution office  "),  and,  still  more  frequently,  with  her  blind 
and  blundering  misuse  of  specifics,  does  sometimes  "cure" 
her  cases  ;  but  this  is  not  the  kind  of  cure  that  should  satisfy 
the  physician's  desires.  It  is  neither  safe  (inasmuch  as  it 
is  debilitating  in  itself  and  is  likely  to  involve  damaging 
sequelae),  nor  rapid,  nor  pleasant.  Thus,  likewise,  we 
know  that  Homceopathists  who  mix  medicines,  whether  in 
the  tumbler  or  in  the  patient's  stomach  (conglomerators  or 
alternators),  do  often  "  cure  "  their  patients.  These  cures, 
if  our  observations  be  correct,  are  neither  so  rapid  nor  so 
pleasant  (free  from  sequelae)  as  cures  might  be ;  and  we  are 
confident  that  by  these  methods  not  nearly  so  large  a  pro- 
portion of  the  sick  may  be  cured  as  by  adherence  to  the 
simple,  single  remedy.  Still,  we  admit  that  when  a 
physician  has  cured  a  patient,  by  whatever  method,  he  has, 
in  so  far  as  that  patient  is  concerned,  done  the  chief  part  of 
his  duty.  Though  his  method  were  not  the  best  of  known 
methods,  he  is  not  to  be  blamed  without  qualification. 

2.  But,  although,  from  the  ethical  stand-point,  we  may 
concede  that: 

"  '  T  is  better  to  have  "  erred  and  cured 
"  Than  never  to  have  "  cured  "  at  all," 

we  think  there  is  abundant  reason  for  cautioning  the  prac- 
titioner to  beware  of  confounding  the  misfortune  of  the  error, 
with  the  good -luck  of  the  cure. 

As  one  to  whom  have  been  confided  the  interests  of  that 
individual  patient,  he  may  justly  rejoice  in  the  cure  ;  but  do 
his  functions  cease  here  ?  By  no  means.  He  is  a  man  of 
science,  to  whose  care  are  to  be  intrusted,  every  day  of  his 


1 68  ALTERNATION   OF  REMEDIES.      NO.    2. 

active  professional  life,  case  after  case  of  disease  which  he  is 
to  bend  his  energies  to  cure.  What  is  it  to  be  a  man  of 
science  ?  It  is  to  be  one  whose  mind  is  stored  with  an  array 
of  facts  carefully  observed  by  others  as  well  as  by  himself, 
and  methodically  arranged,  in  such  wise  that  principles  have 
been  and  may  be  correctly  inferred  from  them  —  principles 
by  virtue  of  which  new  observations  may  be  arranged  along 
with  these  facts — principles  by  the  aid  of  which  the  facts 
which  will  result  from  operations  observed  to  be  in  progress, 
or  intentionally  put  into  activity,  may  be  accurately  predicted, 
and,  conversely,  may  be  produced  at  pleasure. 

Such  is  the  scientific  physician.  Let  us  note  the  difference 
between  the  action  of  his  mind  and  that  of  the  patient,  after 
a  cure  of  the  latter  has  been  accomplished  by  the  former. 
The  patient  says  to  himself,  "  I  was  sick  and  now  I  am  well. 
I  will  pay  my  doctor  and  then,  to  my  work  again  ! "  This  is 
all  his  sickness  is  to  the  patient 

The  soliloquy  of  the  doctor  will  depend  very  much  upon 
the  nature  of  the  mental  process  by  which  he  arrived  at  the 
mode  of  treatment  that  cured  the  patient.  It  may  be : 

1.  "  How  can   I  ever  be  thankful  enough  for  the  lucky 
accident  that  made   me  give  him   Ledum  !     May  I  be  as 
fortunate  when  I  guess  again  ! "  or, 

2.  "  When  I  gave  Bryonia  alone  and  Sepia  alone,  though 
each  seemed  to  correspond  pretty  well,  still  the  patient  did 
not  get   much  better.     But  when  the    happy  thought  of 
alternating  them  occurred  to  me,  and  I  did  it,  she  recovered. 
From  this  I  shall  learn  that  two  remedies,  each  of  which 
corresponds  to  part  of  a  case,  may  cure  the  case  if  given 
in  alternation,   when   neither,    if  given  singly,  would    cure 
it;"  or, 

3.  "  A  year  ago  I  should  have  given,  for  such  an  angina 
as  this,  Belladonna  and  Mercurius  in  alternation,  as  Rummel 
recommends,  and  the  patient  would  probably  have  gotten 
well  in  two  or  three  days  and  I  should  have  been  satisfied ; 
but  since  I  have  studied  Lachesis,  I  find  that  remedy  covers 


ALTERNATION   OF   REMEDIES.      NO.    2.  169 

the  whole  case  much  better  than  Belladonna  and  Mercurius 
would  do ;  and  lo  !  he  is  well  in  twelve  hours.  From  this,  I 
learn  to  shun,  more  earnestly  than  ever,  those  expedients 
which,  like  alternation,  are  borrowed  from  the  polypharmacy 
of  the  Old  School  and  which,  being  opposed  to  sound  prin- 
ciple, must  be  inferior  in  their  results  to  some  better  way 
which  accords  with  sound  principles  and  which  way  I  shall 
be  most  likely  to  find  out  if  I  make  my  practice  follow  prin- 
ciple. This  case,  then,  gives  me  fresh  zeal  in  my  study  of 
Materia  Medica ;"  or, 

4.  "This  case  cost  me  much  study.  I  saw  that  the  symp- 
toms of  the  abdomen  and  digestive  canal  as  well  as  those  of 
the  lumbar  region  and  of  the  hip  and  thigh  and  the  general 
conditions  of  aggravation  and  amelioration  corresponded 
admirably  to  Colocynth,  but  then,  the  patient  had,  in  addi- 
tion, an  enlarged  ovary  (from  which,  possibly  in  some  way, 
the  other  symptoms  sprang),  and  I  have  never  heard  of 
Colocynth  in  connection  with  enlarged  ovary.  I  might, 
therefore,  have  been  tempted  to  alternate  Colocynth  with 
some  remedy  which  is  known  to  have  cured  and  perhaps 
produced  enlarged  ovary,  such  as  Lachesis,  Apis,  Graphites, 
Lycopodium,  Staphysagria,  etc.,  but  for  my  aversion  to 
disregard  what  seems  to  me  the  well-established  principle : 
that  maladies  are  not  local  affections,  but  general,  pervading 
the  entire  organism  —  that  the  individual  man  is  not  an 
aggregation  of  independent  monads,  each  of  which  may  be 
ill  or  get  well  '  on  its  own  hook,'  without  its  neighbor  being 
thereby  jostled,  and  against  which  may  be  discharged  a  cor- 
responding load  of  medicinal  monads  each  of  which  will  find 
its  own  particular  target  without  hitting  any  other — not  this, 
but  an  individual  being,  whose  functions  and  tissues  are  so 
intimately  connected,  that,  '  if  one  member  suffers,  all  the 
members  suffer;'  and  conversely,  if  we  get  the  key  to  the 
malady  by  finding  the  characteristic  symptoms  which  will 
point  us  to  the  true  remedy,  we  shall  cure  the  entire  suffer- 
ing, to  whatever  member  we  may  address  ourselves.  In  this 


I/O  ALTERNATION   OF    REMEDIES.      NO.    2. 

faith,  regarding  the  characteristic  symptoms  as  calling 
unmistakably  for  Colocynth  (there  was  nothing  character- 
istic of  any  remedy  in  the  ovarian  symptoms — the  ovary  was 
enlarged,  that  was  all),  I  give  that  remedy.  And  now,  while 
in  a  few  days  the  other  symptoms  which  plainly  called  for 
Colocynth  disappeared  (permanently,  as  the  event  proved), 
in  the  space  of  two  months  the  ovarian  tumor  had  likewise 
disappeared,  and  the  patient,  who  had  been  confined  for  six 
years  to  her  room  and  couch,  could  now  walk,  drive,  and  go 
about  the  house  as  well  as  ever.1  From  this  I  learn  the 
unity  of  disease,  and  by  this  I  am  strengthened  in  my  belief 
that  adherence  to  well-settled  principles  will,  in  the  end, 
carry  one  farther  and  faster,  even  over  dark  and  uncertain 
ways,  than  any  make-shift  and  irrational  expedient  would  be 
likely  to  do  ;  "  or, 

5.  "In  this  case  of  dysmenorrhoea  the  symptoms  of  the 
head  and  eyes  are  very  characteristic  of  Cyclamen.  But, 
surely,  the  menstrual  symptoms  are  too  important  to  be 
overlooked  in  this  case,  and  the  remedy  must  correspond  to 
these  symptoms  in  order  to  cover  the  case.  I  looked  for 
the  symptoms  of  Cyclamen  on  the  female  sexual  organs, 
and  lo  !  none  are  recorded  in  the  Materia  Medica  Pura.  It 
seems  that  there  was  not  a  woman  among  the  early  provers 
of  Cyclamen.  What  was  to  be  done  ?  The  menstrual 
symptoms  corresponded  pretty  well  with  those  of  Pulsatilla, 
though  the  head  and  eye  symptoms  did  not  correspond. 
Should  I  alternate  Cyclamen  and  Pulsatilla,  which  jointly 
cover  the  case?  I  should  have  high  authority  for  such 
a  course !  But,  I  reflect,  that  the  same  kind  of  a  human 
organism  which,  under  some  disease-producing  influence, 
experiences,  at  one  and  the  same  time,  the  amenorrhcea  and 
the  head  and  eye  symptoms  of  my  patients — the  same  kind 
of  human  organism,  I  say,  experienced  also,  when  proving 
Cyclamen,  head  and  eye  symptoms  exactly  like  those  of 
my  patient.  Is  it  not  fair  to  presume  that,  if  this  disease- 

lSee  "Observations  on  Colocyntk." 


ALTERNATION   OF   REMEDIES.      NO.    2.  171 

producing  cause  and  the  specific  properties  of  Cyclamen  are 
so  nearly  alike  as  to  produce  identical  symptoms  in  the  head 
and  eyes,  they  would  have  produced  identical  symptoms 
likewise  in  the  female  sexual  organs,  had  the  prover  of 
Cyclamen  been  a  woman?  So  strongly  did  probabilities 
seem  to  me  to  favor  this  presumption,  that  regarding  alter- 
nation as  an  unsound  and  irrational  expedient,  I  was  about 
to  take  the  risk  of  giving  Cyclamen  alone  on  the  strength 
of  this  anticipated  result  of  some  future  proving  by  a 
woman,  when,  chancing  to  meet  with  the  new  Austrian 
proving  of  Cyclamen,  I  found  that  provings  by  women  are 
there  recorded  which  confirmed  my  presumption  in  every 
particular.  The  case  recovering  speedily  under  Cyclamen, 
I  learn  from  it  that  in  many  cases  we  are  tempted  to  alter- 
nate because  we  cannot  cover  every  feature  of  the  case  with 
either  of  the  remedies  which  we  think  of  alternating.  But, 
in  some  of  these  cases,  the  symptoms  which  are  really 
characteristic  are  fully  met  by  one  of  these  remedies,  and 
there  is  ground  for  assuming,  as  clinical  records  show,  that 
subsequent  and  more  extended  provings  will  demonstrate  to 
us  that  this  remedy,  if  fully  proved,  would  really  cover  the 
entire  case,  characteristics  and  all.  This  experience  fortifies 
me  against  a  temptation  to  alternate,  and  leads  me  to  rely 
more  confidently  on  the  indications  furnished  by  character- 
istic symptoms." 

If  we  review  these  cases  and  analyze  the  operations  of  the 
physician's  mind,  we  shall  see  that,  in  number  one,  he  con- 
fesses that  he  has  been  the  '*  accident  of  an  accident,"  and 
he  invokes  his  "  good  luck "  to  stand  him  in  stead  again. 
He  does  not  exercise  his  reasoning  faculties  at  all.  Let 
him  pass. 

In  the  other  cases,  there  is,  besides  a  thanksgiving  for 
success,  an  effort  of  the  mind  to  arrange  the  facts  which  the 
case  presents  in  order,  along  with  some  other  facts  already 
stored  there,  and  to  infer  from  the  aggregate  store  of  facts 
some  principle  or  plan  of  action  which  may  be  profitably 


1/2  ALTERNATION    OF    REMEDIES.       NO.    2. 

brought  to  bear  on  some  future  case.  It  is  thus  and  only 
thus  that  "experience  teaches"  For,  since  no  two  cases  are 
ever  met  with  that  are  in  every  respect  precisely  alike,  the 
experience  acquired  in  treating  one  case  can  never  be  avail- 
.able  in  treating  another,  except  through  the  intermediate 
application  of  the  reasoning  powers.  We  hear  and  observe 
facts,  collect  and  arrange  them,  analyze  and  reflect  upon 
them,  induce  principles  from  them,  and  prepare  ourselves  to 
make  practical  application  of  these  principles  when  a  new 
case  shall  call  for  it. 

Now,  what  is  this  but  theorizing  ?  When  we  analyze  a 
case  in  such  a  way  as  to  suggest  to  our  minds  its  proper 
mode  or  course  of  action,  or  to  infer  from  it  any  principle 
that  might  help  us  in  a  future  case,  we  form  a  "  theory." 
We  cannot  think,  indeed,  about  collecting  facts  without 
theorizing. 

Yet  the  defenders  of  alternation  invite  us  simply  "  to  look 
and  see,"  to  "  establish  facts.  These  once  fixed,  any  theory 
which  will  perfectly  account  for  them  is  good."  These 
are  Dr.  Hawley's  words.  *  And  the  London  Homoeopathic 
Review,  vol.  ix.,  p.  432,  quotes  Dr.  Hawley's  words  approv- 
ingly:  "  The  homoeopathic  system  of  medicine,"  *  *  * 
says  Dr.  Hawley,  "  bases  itself,  not  on  theories  but  on  facts 
as  they  are  observed  in  the  world  of  man.  It  frees  its  dis- 
ciples from  all  dogmas  and  simply  asks  them  to  look  and 
see."  Well,  being  thus  invited,  we  "look  and  see."  What 
do  we  see  ?  Why  we  see  Dr.  Hawley  giving  Bryonia  and 
Sepia  in  alternation  in  one  chronic  case  and  Arsenic  and 
China  in  another  case,  and  curing  both  in  a  way  which 
satisfies  him  well.  This  is  what  we  see.  But  what  does  Dr. 
Hawley  see  when  he  looks  at  these  same  facts  ?  Why  he 
sees  something  which  proves  to  him  that  "  for  him,  the  use 
of  remedies  in  alternation  is  better  than  the  use  of  a  single 
remedy."  And  the  London  Review  sees  in  the  same  facts 
something  "which  proved  to  him  (Dr.  Hawley)  that  the 

1  American  Homoeopathic  Review,  vol.  v.,  p.  338. 


ALTERNATION   OF   REMEDIES.      NO.    2.  173 

alternation  of  medicines  is  not  only  admissible,  but  that 
cases  now  and  then  occur  which  CAN  ONLY  BE  CURED  BY 
SUCH  ALTERNATION." 

Is  not  this  "theorizing"  pretty  strongly  and  on  a  rather 
slender  basis  ?  Our  friends  warn  us  against  "  theory  "  and 
yet,  from  two  facts,  Dr.  Hawley  concludes  that,  "  for  him, 
the  use  of  remedies  in  alternation  is  better  than  the  use  of 
a  single  remedy."  From  the  same  two  facts  the  London 
Review  makes  Dr.  Hawley  conclude  that  "  cases  now  and 
then  occur,  which  CAN  ONLY  BE  CURED  BY  SUCH  ALTER- 
NATION." This  is  a  broad  generalization  on  a  very  narrow 
foundation.  But  Dr.  Hawley  admonishes  us  that  "  we  have 
not  yet  any  such  collection  of  facts  as  will  warrant  any 
generalization" 

For  ourselves,  we  should  not  feel  justified  in  drawing  any 
such  conclusions  as  these  from  Dr.  Hawley's  cases  or  from 
any  of  the  cases  already  narrated,  cured  by  alternation. 
When  adduced  in  evidence,  we  accept  them  as  facts  and 
give  them  what  we  consider  to  be  their  full  value.  They 
prove  to  us  that  cases  may  be  cured  by  alternated  remedies, 
but  they  prove  no  more  than  that.  They  prove  that  two 
remedies  in  alternation  cured  a  case  which  neither  of  those 
two  remedies  singly  had  cured.  Beyond  this  they  prove 
nothing.  Assuredly  they  do  not  prove  that  a  physician 
could  not  have  cured  each  case  more  quickly  with  some 
other  remedy,  given  singly.  How  could  such  evidence  be 
held  by  us  to  justify  such  conclusions  as  Dr.  Hawley  and 
his  reviewer  draw  from  it,  when  our  daily  experience  fur- 
nishes case  after  case  which  had  been  treated  ineffectually  by 
physicians  who  always  alternate  and  which  yields  promptly 
to  the  single  remedy.  Evidence  of  this  kind  whether  FOR 
or  AGAINST  alternation,  will  not  settle  this  question. 

These  remarks,  extended  as  they  are,  have  been  made  for 
the  purpose  of  showing  that  clinical  experience  is  available 
as  a  means  of  improvement  in  medical  practice  only  in  so 
far  as  it  is  analyzed,  thought  about,  and,  in  fact,  "theorized" 


174  ALTERNATION    OF   REMEDIES.       NO.    2. 

about;  that  those  who  deprecate  dogmatism  and  would  put 
off  the  formation  of  generalizations,  do,  themselves,  dogmatize 
and  theorize,  and  from  the  nature  of  the  case  they  -must  do  so 
in  the  act  of  reasoning  about  the  evidence  they  bring  forward. 

If  this  be  inevitable,  then,  it  must  be  allowed  us  likewise 
to  theorize  and  in  what  we  have  to  say  about  alternation 
we  shall  hold  ourselves  justified  in  basing  our  argument  on 
generalizations  from  a  multitude  of  collated  facts.  We  hold 
that  the  argument  from  theory  is  in  order.  And  regarding 
a  SCIENCE  as  being  a  connected  and  independent  series  of 
generalizations  based  on  an  analysis  of  methodically  arranged 
and  collated  facts,  we  require  the  advocates  of  alternation  to 
rest  their  cause,  as  we  do  our  opposition  to  alternation,  on 
such  a  generalization.  Failing  to  do  this,  they  have  no  claim 
for  their  method  as  a  part  of  the  SCIENCE  of  Therapeutics. 
Failing  this,  the  facts  which  seem  to  justify  alternation  can 
be  used  in  no  other  way  than  in  the  blind,  empirical  way  of 
literal  imitation,  in  which  accuracy  and  certainty  are  quite 
out  of  the  question.  But  our  whole  object  in  study  and 
labor,  beyond  the  direct  need  of  our  patients,  is  to  complete 
the  structure  of  our  science,  such  as  we  have  defined  a 
Science  to  be,  a  means  of  attaining  accuracy  and  certainty. 

Some  of  the  advocates  of  alternation  have  failed  to  per- 
ceive the  necessity  of  raising  their  procedures  to  the  level  of 
a  scientific  method.  They  still  rest  on  the  rude  empirical 
ground  of  unmethodized  experience.  Their  argument  is : 
"  I  have  alternated  remedies  which,  singly,  had  failed,  and  I 
cured.  Henceforth  I  shall  alternate."  Or,  as  the  London 
Review  varies  the  argument  (9,  432),  "  The  practice  of  alter- 
nation of  remedies  is  one  so  widely  adopted  that  it  would 
appear  to  have  the  sanction  of  very  extended  practical 
experience.  Experience  has  proved 

abundantly  that  the  alternation  of  remedies  increases  the 
rapidity  of  the  cure,"  etc.  The  same  argument  was  used  by 
Dr.  Coxe,1  who  claims  to  have  alternated  for  twenty-five 

1  American  Homoeopathic  Review,  iii.,  59. 


ALTERNATION    OF    REMEDIES.      NO.    2.  175 

years,  and  to  have  been  successful.  As  we  have  before 
remarked,  the  same  argument  may  be  used  by  Allopathists, 
and  by  the  advocates  of  every  form  of  practice,  whether 
pure,  mixed,  or  wholly  vicious.  The  same  argument  may 
be,  and  is,  advanced  by  those  who  oppose  alternation. 

Others,  however,  have  seen  the  necessity  of  basing  their 
advocacy  of  alternation  on  some  general  principles,  among 
them  particularly  Dr.  Drysdale 1  and  Dr.  Coe,2  and  to  these 
statements  of  principles  we  wish  to  devote  some  attention. 

But,  first,  let  us  have  a  clear  understanding  of  what  is 
properly  meant  by  alternation  of  remedies. 

As  we  have  stated,  the  term  is  used  in  different  senses. 

i.  Dr.  J.  R.  Coxe  (loc.  cit.)  seemed  to  think  that  the 
opponents  of  alternation  contend  that  each  case  of  sickness 
should  be  treated  with  one  single  remedy,  and  that,  if  during 
an  illness  a  change  in  the  symptoms  should  compel  a  change 
in  the  remedy,  this,  by  whatever  name  it  be  called,  is,  in 
fact,  alternation.  He  scouts  the  idea  of  any  real  distinction 
between  alternation  and  succession  of  remedies.  Well,  if 
this  be  all  that  alternation  means,  we  have  no  reason  to 
oppose  it.  But,  what  is  a  case  of  disease  in  this  sense  ?  Does 
it  comprise  all  that  may  ail  a  man  from  the  time  that  he 
takes  to  his  bed  to  the  time  that  he  goes  to  his  work  again  ? 
Suppose  a  patient  sick  of  dysentery,  and  recovering  finely 
under  the  single  remedy  Mercurius  corrosivus.  When  just 
convalescent  he  is  seized  with  rheumatism,  and  requires 
Rhus  toxicodendron.  Is  it  "alternating"  to  give  it  to  him? 
And  then,  suppose  him  safely  over  rheumatism  ;  but  just 
before  he  goes  to  work  again,  he  has  a  return  of  dysentery, 
requiring  Mercurius  corrosivus.  Is  it  "  alternating  "  to  give 
it,  if  the  symptoms  require  it  ?  And  if,  when  cured  of  this 
relapse,  he  gets  the  measles  and  requires  Euphrasia,  is  it 
"alternating"  again  to  give  him  this  remedy?  Why, 
according  to  this  definition,  if  you  call  this  all  one  sickness, 

1  Annals  of  British   Homoeopathic  2  The  American  Homoeopathic  Rt~ 

Society.  view,  vol.  v.,  April,  1865. 


ALTERNATION    OF   REMEDIES.      NO.    2. 


it  has  been  a  case  of  alternation.  If  you  call  it  four  sick- 
nesses, perhaps  not.  To  the  patient,  certainly,  it  is  "all 
one,"  whatever  you  call  it  !  Now,  suppose  the  symptoms 
in  a  case  to  have  changed  just  as  decidedly  as  in  the  case 
supposed  above,  but  yet  not  so  definitely  as  to  induce  you 
to  give  to  the  changes  these  nosological  names  of  dysentery, 
rheumatism  and  measles.  The  medicines,  Mercurius,  Rhus 
and  Euphrasia  will  have  been  just  as  clearly  indicated  by 
these  successive  changes,  and  just  as  imperatively  required 
as  though  the  patient  were  regarded  as  having  had  four 
successive  diseases.  Is  it  "  alternation  "  to  give  these 
remedies  successively  just  as  they  become  clearly  indicated  ? 
We  think  it  is  not,  but  some  say  it  is.  We  are  sure  it  is 
sound  practice. 

2.  Dr.  Quin,  of  London,1  calls  the  method  of  prescribing 
successive  remedies   in   a   case  as  the  changes  of  symptoms 
may  require  them,   "alternation  a  posteriori"  and  sanctions 
and   defends   it.     But    he   reprobates,    under    the    name    of 
"alternation  a  priori"  the  practice  which,  it  seems  to  us,  is 
the   only  one  which   can   properly  be  called  "  alternation," 
viz.  : 

"  Prescribing  at  the  very  outset  of  the  treatment  —  at  the  very  first  visit  and 
also,  not  unfrequently,  almost  at  every  subsequent  visit,  two  or  more  medicines, 
to  be  alternated  every  quarter,  half  hour,  or  every  two,  three,  or  four  hours. 
It  is  difficult  to  believe,"  he  continues,  "  that  such  practitioners  are  in  the  habit 
of  carefully  considering  the  cases  under  treatment,  or  have  well  studied  their 
Materia  Medica,  or  to  divest  one's  self  of  the  idea  that  they  resort  to  such  slip- 
shod practice  in  the  hope  that  if  one  of  the  medicines  does  not  hit  off  the 
complaint,  some  one  of  the  others  may.  One  meets  with  instructions  for 
similar  alternation  laid  down  in  popular  books  on  Homoeopathy,  showing  that 
this  a  priori  style  of  alternating  remedies  is,  with  certain  practitioners,  more  a 
rule  than  an  exception." 

3.  Dr.  Drysdale  defines  alternation  to  be  "the  giving  a 
second  medicine  while  the  sphere  of  action  of  the  first  is  still 
unexhausted."     But  Dr.  Drysdale,   while   advocating  alter- 
nation, in  this  sense,    in   certain    specified   cases,  does   not 
propose  to  give  his  second  medicine  except    after  a  careful 

1  Annual  Address,  Annals  of  British  Homoeopathic  Sodety. 


ALTERNATION   OF   REMEDIES.      NO.    2.  177 

re-examination  of  the  symptoms  of  the  patient,  and  a  com- 
parison of  them  with  the  Materia  Medica.  It  is  clear,  then, 
that  alternation  as  he  defines  and  defends  it,  is  not  the  same 
thing  as  the  alternation  a  priori  which  Dr.  Quin  reprobates, 
and  to  which  we  would  restrict  the  term.  Dr.  Drysdale's 
definition  seems  to  us  very  vague  and  impracticable.  How 
are  we  to  know  when  the  sphere  of  action  of  the  medicine 
is  exhausted  ?  By  inferences  from  the  proving  ?  But 
we  have  reason  to  believe  that  the  speed  at  which  vital 
processes  go  on  in  sickness  may  be  very  different  from  that 
during  a  physiological  proving.  Reduced  to  a  practical 
rule,  Dr.  Drysdale's  reasoning  would  amount  to  this :  If,  on 
our  second  visit,  symptoms  shall  be  found  to  have  arisen 
which  seem  to  call  for  the  second  medicine,  we  should 
suspend  the  first  and  give  the  second,  and  then,  if,  at  the 
third  visit,  the  symptoms  be  found  to  have  changed  again, 
so  as  to  call  again  for  the  first  medicine,  we  should  give  it. 
But  this,  he  says,  is  "alternation."  With  certain  qualifica- 
tions we  agree  to  his  rule  of  practice,  but  we  object  to  the 
name  he  gives  it.  And  here  names  are  important.  It  is  of 
great  consequence  to  avoid  giving  to  two  radically  different 
procedures  one  and  the  same  name. 

Now,  what  do  we  mean  by  "alternation?"  Let  us  give 
a  practical  answer.  .  We  have  before  us  a  prescription  label 
filled  up  by  Dr.  John  Doe.  It  reads  thus : 

"No.  i,  Aeon.3;  No.  2,  Bellad.6;  of  each,  twelve  pow- 
ders. Take  the  powders  alternately  as  numbered,  every 
four  hours." 

We  have  another  paper  containing  directions  prepared  by 
Dr.  Busy,  for  a  chronic  patient : 

"Take  as  follows:  Mercurius  hydriod.,  first  decimal  tritu- 
ration,  every  night  for  seven  nights; 

"Then  Sulphur3,  every  night  for  seven  nights; 

"Then  Collinsonia1,  every  night  for  seven  nights; 
13 


178  ALTERNATION   OF   REMEDIES.      NO.    2. 

"  Then  Podophyllum  pelt.2,  every  night  for  seven  nights ; 
"Then  Ignatia3  and  China1,  alternately  every  night  and 
morning,  for  seven  days  ; 

"Then  Aurum  met.1,  every  night  for  seven  nights; 
"Then  Pulsatilla1,  every  night  for  seven  nights; 
"Then  Phytolacca  dec.1,  every  night  for  seven  nights." 

We  object  to  these,  and  to  all  kindred  procedures,  that 
they  rest  on  hypotheses  which  are  not  warranted  by  the 
present  possibilities  of  science.  Dr.  John  Doe's  first  pre- 
scription of  Aconite  may  be  all  right;  the  symptoms 
probably  call  for  it.  But  the  physician  cannot  know  in 
advance  that,  in  four  hours,  the  symptoms  will  have  so 
changed  that,  if  he  were  present,  he  would  perceive  Bella- 
donna to  be  indicated ;  and  that,  in  four  hours  later,  Aconite 
will  be  indicated  again ;  and  that  the  symptoms  will  go  on, 
oscillating  between  these  two  series  of  indications,  each 
oscillation  consuming  just  four  hours. 

And  "  Dr.  Busy,"  by  what  wonderful  gift  could  he  foresee 
that  seven  days  of  Mercurius  hydrargyrum  would  bring  his 
patient  to  a  state  requiring  Sulphur,  and  seven  days  of 
Sulphur  to  a  state  requiring  Collinsonia  (whatever  that  state 
may  be),  and  seven  days  of  Collinsonia  to  a  state  calling  for 
Podophyllum  (and  for  just  seven  days  of  it  too),  and  seven 
days  of  Podophyllum  to  a  state  of  complex  misery  that  calls 
for  China  and  Ignatia  in  alternation  (for  just  seven  days 
likewise)  and  so  on  to  the  end  of  this  long  chapter ! 

"  Oh,  wad  some  power  that  giftie  gie  us!  " 

These  instances,  and  the  comments  upon  them,  comprise 
our  definition  of  "alternation,"  and  our  objection  to  it.  It 
is  a  practice  very  prevalent  in  the  United  States  and  in 
England.  It  is  exceptional  in  Germany,  France,  Spain  and 
Italy. 

The  principles  which  govern  the  selection  and  administra- 
tion of  homoeopathic  remedies  are  very  simple. 


ALTERNATION   OF   REMEDIES.      NO.    2.  179 

The  great  law,  SIMILIA  SIMILIBUS  CURANTUR,  teaches 
us  to  select  a  remedy  the  characteristic  pathogenetic  symp- 
toms of  which  are  very  similar  to  those  of  the  patient. 
This  is  a  grand  generalization,  supported  by  a  multitude  of 
facts.  We  accept  it.  It  takes  no  heed  of  names  of  diseases, 
nor  of  pathological  theories  of  the  seat  and  origin  of  diseases. 
Giving  a  broad  and  liberal  signification  to  the  word  "  symp- 
tom," so  as  to  include  everything  abnormal  about  the 
patient,  whether  it  be  historical  or  actual,  this  law  pays 
regard  to  the  symptoms  alone.  It  requires  that  the  symp- 
toms shall  be  collected  and  compared  with  the  Materia 
Medica  every  time  a  prescription  is  made,  and  that  the  drug 
that  has  produced  symptoms  most  similar  to  those  of  the 
patient  shall  be  chosen  and  given.  This  is  a  true  homoeo- 
pathic prescription.  No  matter  how  often  during  the  sick- 
ness of  a  patient  this  process  be  repeated ;  no  matter  how 
many  remedies  be  given  in  succession ;  no  matter  if  the 
first  remedy  be  recurred  to  after  the  second  and  the  second 
after  the  first — if  each  prescription  have  been  the  fruit  of  a 
special  collection  of  symptoms  and  comparison  of  them  with 
the  Materia  Medica — call  it  "alternation"  or  by  whatever 
other  wrong  name  you  please,  it  is  a  sound  and  defensible 
homoeopathic  prescription,  such  as  Hahnemann  taught  and 
practiced,  and  his  followers  adopted. 

But  the  physician  sometimes  leaves  a  second  remedy  to 
be  substituted  for  the  first  under  certain  specified  contingen- 
cies. Is  this  alternation  ?  By  no  means.  In  so  doing,  he 
makes  the  attendant  his  deputy,  and  describes  the  series  of 
symptoms  which,  in  his  judgment,  will  be  an  indication  that 
another  remedy  is  required.  He  is  merely  instructing  and 
empowering  another  person  to  make,  in  his  stead,  the  study 
and  selection  of  a  remedy  which  should  precede  and  be  the 
basis  of  every  new  prescription. 

And  wherever,  in  his  writings,  Hahnemann  has  seemed 
to  authorize  or  sanction  alternation,  his  directions  have  been 
of  this  character.  He  has  mentioned  that  a  certain  group 


180  ALTERNATION    OF    REMEDIES.       NO.    2. 

of  remedies  is  likely  to  be  indicated  in  a  certain  disease,  and 
although  he  has  sometimes  used  the  word  "  alternate " 
(abwechseln),  yet,  in  every  case,  he  has  specified  the 
particular  symptoms,  or  groups  of  symptoms,  which  would 
specially  indicate  and  authorize  the  preference  to  be  given 
to  one  or  another  remedy  of  these  groups. 

In  a  previous  paper1  we  showed  this  to  be  true  of 
Hahnemann's  directions  for  the  use  of  Spongia,  Hepar  and 
Aconite  in  croup,  and  also  for  Bryonia  and  Rhus  in  typhoid 
fever.  The  same  is  true  of  his  directions  touching  cholera. 

The  London  Homoeopathic  Review  ~  says :  "  Those  who 
combat  '  Alternation  '  on  the  ground  that  it  is  opposed  to 
the  practice  of  Hahnemann,  fall  into  a  grave  error.  In  the 
introduction  to  Belladonna  in  his  Materia  Medica  Pura,  he 
advises  the  alternation  of  Aconite  and  Coffea  cruda  in  purple 
rash,  in  these  words :  '  Aconite  and  Coffea  should  be  alter- 
nately given  every  twelve,  sixteen  or  twenty-four  hours,  in 
proportion  as  one  or  other  remedy  is  indicated.' ' 

It  is  true  that  the  above  words  are  contained  in  the  intro- 
duction to  Belladonna,  but  they  are  not  all  the  words  con- 
tained in  the  sentence  from  which  they  are  quoted.  This 
sentence,  complete,  is  as  follows:  "There  (in  the  purple  rash) 
Belladonna,  naturally,  does  no  good,  and  the  other,  common, 
charlatan  treatment  must  also  allow  the  most  of  the  patients 
to  die  of  it,  whereas  they  might  all  be  cured  by  the  alternate 
use  of  Aconite  and  of  the  tincture  of  Coffea  cruda,  the 
former  for  the  heat  and  the  increasing  restlessness  and 
agonizing  anxiety,  the  latter  for  over-excessive  pains  with  a 
lachrymose  humor ;  the  Aconite  in  the  3Oth  dilution  of  the 
juice  and  the  tincture  of  Coffea  cruda  in  the  3d  dilution, 
both  in  the  dose  of  the  smallest  part  of  a  drop,  the  one  or 
the  other  every  twelve,  sixteen  or  twenty-four  hours,  accord- 
ing as  the  one  or  the  other  is  indicated."  The  two  groups  of 
symptoms  which  Hahnemann  gives  as  indications,  respect- 

1    American    Homoeopathic    Revinv,  *  Vol.  ix.,  p.  432. 

April,  1863. 


ALTERNATION   OF    REMEDIES.      NO.    2.  igl 

ively,  for  the  one  or  the  other  of  these  remedies,  are  omitted 
by  the  London  Review.  They  are  the  essence  of  the  whole 
matter.  Following  this  advice  of  Hahnemann,  it  would  not 
be  possible  for  the  practitioner,  on  meeting  a  case  of  purple 
rash,  to  begin  with  a  blind  a  priori  alternation  of  Aconite 
and  Coffea.  On  the  contrary,  as  we  understand  Hahne- 
mann's  direction,  he  should  examine  his  case  to  see  whether 
it  presented  the  groups  of  symptoms  "  heat,  increasing  rest- 
lessness and  agonizing  anxiety,"  in  which  case  he  would 
give  Aconite;  or  whether  the  characteristics  of  the  case 
were  "  over-excessive  pains  with  a  lachrymose  humor,"  in 
which  case  he  would  give  Coffea.  Suppose  at  his  next  visit, 
twelve,  sixteen  or  twenty-four  hours  after,  he  should  find,  as 
might  well  happen,  that  the  group  of  symptoms  first 
observed  had  disappeared  and  had  given  place  to  the  other 
group,  he  would,  for  this  reason,  change  his  remedy.  Or,  if 
he  lived  at  a  distance  from  the  patient,  he  might  make  the 
nurse  his  deputy,  and,  instructing  this  deputy  as  to  the 
distinction  between  the  groups  of  symptoms,  might  direct 
her  (as  Hahnemann  has  directed  us)  to  make  changes  in  the 
remedies  when  corresponding  changes  in  the  symptoms 
should  call  for  them.  In  this  way  there  would  be  no 
assumption  and  no  a  priori  "alternation."  The  practice 
would  be  sound,  fulfilling  the  conditions  of  a  sound  prescrip- 
tion, viz.  :  that  each  prescription  be  preceded  by  a  fresh 
collection  of  the  symptoms  of  the  case,  and  comparison  of 
them  with  the  Materia  Medica. 

Is  it  suggested  that  Hahnemann  meant  to  intimate  that 
these  groups  of  symptoms  might  co-exist  in  the  patient  at 
the  same  time  and  might  make  a  "totality  of  symptoms" 
that  would  require  these  two  remedies  to  cover  it  ?  But 
these  groups  are  pathologically  incompatible.  No  one  con- 
versant with  the  phenomena  of  sickness  could  conceive  of  a 
patient  presenting,  at  one  and  the  same  time,  "  heat,  increas- 
ing restlessness  and  agonizing  anxiety,"  and  likewise  over- 
sensibility  to  pain  and  a  disposition  to  weep  and  despond.  No ! 


1 82  ALTERNATION   OF   REMEDIES.      NO.    2. 

patients  in  a  waxing  fever  often  swear ;  but  they  seldom  pine 
and  weep ;  they  feel  general  anguish  but  make  light  of  specific 
pains.  But  when  the  fever  has  waned,  there  often  succeeds 
it  a  stage  of  over-sensibility  and  of  proneness  to  weep ;  and 
this  succession  may  be  repeated  again  and  again,  and  we  sup- 
pose Hahnemann  recommended  these  remedies  to  corre- 
pond  to  this  succession.  We  cannot  comprehend  his  words 
in  the  sense  attached  to  them  by  the  London  Review.  In 
the  signification  in  which  we  have  understood  them,  they 
correspond  precisely  to  all  of  his  other  directions,  which 
have  been  quoted  as  favoring  "alternation." 

But,  now,  suppose  it  conceded  that,  while  Hahnemann's 
practical  deductions  from  scientific  principles  were  opposed  to 
"  alternation,"  his  practice  sanctioned  it.  Is  the  argument 
from  his  practice  all  powerful  against  his  principles?  This 
reminds  us  of  what  the  Chairman  of  the  British  Society  calls 
Dr.  Drysdale's  Socratic  irony  " — you  all  object  to  alternation, 
and,  yet,  you  all  alternate."  We  have  seen  that  Dr.  Drys- 
dale's definition  of  alternation  is  such  as  to  cover  almost 
every  actual  case  of  treatment  and  is  different  from  that  of 
every  other  writer.  But,  the  argument  from  the  universality 
of  a  practice,  in  favor  of  its  propriety,  is  a  dangerous  one  to 
play  with.  Place  it  in  the  mouth  of  a  theologian  and  see 
how  it  reads :  You  all  condemn  sin,  and  yet,  you  are  all 
sinners!" 

Does  the  weight  of  this  argument  lie  on  the  side  of  sin 
or  on  the  side  of  the  condemnation  of  sin !  Does  propriety 
necessarily  follow  from  universality  ?  Are  the  majority 
always  right,  just  because  they  are  the  majority  ?  If  so,  all 
hail,  Allopathy  ! 

The  conditions  of  a  true  and  defensible  homoeopathic  pre- 
scription require,  in  our  opinion,  that  the  symptoms  of  the 
patient,  at  the  time  of  prescribing,  shall  be  collected  and 
compared  with  the  provings  in  the  Materia  Medica,  and  that 
the  drug  whose  symptoms  correspond  most  closely  with 
those  of  the  patient  shall  be  selected.  Perhaps  no  Homceo- 


ALTERNATION   OF   REMEDIES.      NO.    2.  183 

pathician  would  object  to  this  statement.     But  let  us  see 
what  it  requires. 

First.  It  requires  that  before  every  prescription,  the 
symptoms  of  the  patient  shall  be  studied  anew.  In  some 
way  or  other,  whether  it  be  done  by  the  physician  or  by  a 
provisional  deputy  specially  instructed  for  the  case  (as  we 
have  explained  that  the  nurse  may  be),  more  or  less  perfectly, 
this  must  be  done.  We  have  seen  that  in  the  ordinary 
method  of  alternation  (a  priori)  this  is  not  attempted  to  be 
done  and  cannot  be  done ;  it  is  not  proposed  to  do  it. 

Second.  It  requires  that  the  aggregate  of  the  symptoms 
presented  by  the  patient  be  regarded  as  one  malady,  for 
which  an  analogue  is  to  be  found  in  the  Materia  Medica. 
We  have  no  authority  in  science  for  arbitrarily  dividing  this 
aggregate  °f  symptoms  into  groups,  for  each  of  which  we 
are  to  find  an  analogue  in  the  Materia  Medica,  and  then 
giving  these  analogues,  in  combination,  or  in  alternation. 
This  requirement  is  perhaps  the  most  difficult  of  all  to  fulfill. 
In  collecting  the  symptoms,  our  utmost  sharpness  of  insight 
and  our  deepest  and  most  extensive  learning  in  every  de- 
partment of  physiological,  psychological  and  pathological 
science  will  be  tasked  to  construct,  from  the  patient's  history 
and  from  his  present  condition,  a  complete  picture  of  the 
morbid  phenomena  which  he  presents,  from  which  the 
physiological  idiosyncrasies  of  his  peculiar  temperament  and 
personality  shall  all  have  been  eliminated,  and  in  which  his 
symptoms  shall  be  duly  arranged  with  regard  to  their  mutual 
relations  and  dependencies.  Then,  furthermore,  inasmuch 
as  we  cannot  hope  to  find,  in  the  proving  of  any  drug,  a 
duplicate  symptom  for  every  symptom  of  the  patient,  the 
rarest  judgment  and  most  extensive  knowledge  of  semeiology 
are  required  to  analyze  the  patient's  symptoms  and  to  detect 
those  which  are  truly  characteristic  of  that  individual  case, 
and  for  which  an  analogue  must  be  found  in  the  proving ; 
and  to  set  these  characteristics  apart  from  the  other 
symptoms,  the  analogue  of  which  it  may  be  less  impera- 


1 84  ALTERNATION   OF   REMEDIES.      NO.    2. 

tively  necessary  to  discover.  It  is  here,  undoubtedly,  that 
the  greatest  knowledge  and  ability  are  required  of  the 
physician  and  here  that  failures  are  most  frequently  made. 
It  is,  probably,  from  failures  in  this  analysis  of  symptoms, 
that  the  supposed  necessity  of  alternation  most  frequently 
arises. 

Third.  It  requires  that  a  drug  shall  be  selected  which 
has  produced  on  the  healthy  subject,  symptoms  very  similar 
to  those  of  the  patient.  The  substance  given  must  have 
been  proved  in  the  same  form  (not  necessarily  the  same  dose) 
as  that  in  which  it  is  proposed  to  be  given.  If  Hepar  sul- 
phuris  calcareum  correspond  to  the  case,  this  requirement  is, 
by  no  means,  fulfilled  if  we  give  Sulphur  and  Calcareacarbonica 
combined  or  alternated,  on  the  ground  that  these  substances 
are  the  constituents  of  Hepar  sulphuris  calcareum.  For, 
this  involves  the  assumption  that  the  Sulphur  and  the 
Calcarea  carbonica  have  undergone  no  changes  during  the 
process  which  made,  out  of  them,  that  third  substance — 
Hepar  sulphuris.  No  !  Hepar  sulphuris  was  proved  as  such. 
If  we  select  it,  for  the  reason  that  the  symptoms  which  it 
produced  correspond  to  those  of  the  patient,  then  we  must 
give  Hepar  sulphuris,  the  very  substance  that  was  proved. 
Otherwise  we  plunge  into  a  sea  of  speculation  and  hy- 
pothesis and  forfeit  that  certainty  which  it  was  the  sole 
object  of  our  science  (as  of  every  science)  to  attain.  In  like 
manner,  if  the  Iodide  of  Mercury  had  been  proved  on  the 
healthy  subject  and  its  symptoms  were  most  similar  to  those 
of  our  patient,  it  would  not  be  a  compliance  with  the 
demands  of  our  science  should  we  give,  instead  of  Iodide  of 
Mercury  the  very  substance  that  produced  these  symptoms, 
the  Mercurius  vivus  and  the  tincture  of  Iodine,  assuming 
that,  because  Iodide  of  Mercury  is  a  compound  of  these  two 
substances,  therefore  the  conjoined  or  alternate  action  of  the 
elements  from  whose  union  it  sprang  must  be  identical  with 
its  own.  From  instances  like  these,  it  is  clearly  to  be  seen 
that  we  may  not,  consistently  with  the  principles  of  our 


ALTERNATION   OF   REMEDIES.      NO.    2.  185 

science,  prescribe  drugs  in  any  other  form  or  combination 
than  that  in  which  they  were  proved.  If  drugs  had  been 
proved  in  alternation,  we  might  then  with  propriety,  perhaps, 
prescribe  them  in  alternation.  Until  this  is  done,  the  method 
is  a  hap-hazard,  chance  operation — successful,  no  doubt,  at 
times,  but  in  such  a  way  that  success  could  never  be  fore- 
seen or  insured,  nor  could  the  experience  of  the  practitioner 
in  any  way  serve  to  establish  or  confirm  any  principle  of 
medical  science. 

A  homoeopathic  prescription,  as  we  have  denned  it,  is  a 
deduction  from  a  generalization,  which  has  been  established 
by  induction  from  a  multitude  of  instances.  This  is  the  law 
SIMILIA  SIMILIBUS  CURANTUR,  in  accordance  with  which 
the  remedy  is  selected,  under  the  three  requirements  that 
we  have  specified.  So  well  established  is  this  law  of 
nature,  that  if  we  are  so  fortunate  as  to  be  able,  in  any  given 
case  of  disease,  to  comply  closely  with  those  requirements, 
and  particularly  with  the  second,  we  may  with  certainty 
predict,  and  in  confidence  await,  the  favorable  result  of  our 
prescriptions.  Such  certainty  of  foresight  and  such  confi- 
dence it  is  our  great  object  to  attain,  and  nothing  but  a 
scientific  method  can  afford  them. 

But  we  have  shown  that  alternation,  as  we  use  the  term, 
and  as  we  have  described  the  process,  is  incompatible  with 
this  scientific  method.  It  does  not  meet  the  requirements 
of  the  law.  It  does  not 'take  the  aggregate  of  the  symptoms 
as  the  single  basis  of  prescription.  It  does  not  give  the 
remedy,  single  and  simple,  such  as  it  was  used  in  the  proving. 
But  it  permits  itself  to  act  on  two 'assumptions — that  the 
aggregate  of  the  symptoms  may  be  arbitrarily  divided  and 
separately  prescribed  for ;  and  that  two  or  more  drugs  which 
have  been  proved  independently  of  each  other  may  be  used 
conjointly  as  a  sort  of  composite  analogue  to  the  aggregate 
of  the  symptoms ;  and  all  this  with  equally  good  and  sure 
results.  These  two  assumptions  are  not  even  alleged  to  be 
based  on  any  collection  of  facts.  Their  introduction 


1 86  ALTERNATION   OF   REMEDIES.      NO.    2. 

deprives  the  proceeding  of  all  claim  to  a  strictly  scientific 
process 

The  advocates  and  defenders  of  alternation  are  naturally 
divided  into  two  classes.  The  one  frankly  disavow  any 
pretension  that  alternation  is  a  scientific  deduction  from  a 
general  principle,  and  defend  it  on  the  simple  ground  of 
experience.  They  have  alternated  successfully  in  a  case  or 
cases  like  the  present,  and  therefore  they  do  it  again. 

Now,  obviously,  with  this  class  we  cannot  discuss  the 
question  on  scientific  grounds.  There  is  no  reason  in  their 
method,  because  there  is  in  it  no  reference  to  general  princi- 
ple, to  natural  laws  :  it  gives  no  means  of  foreseeing  and 
providing  for  future  results ;  it  is  the  simplest  form  of  literal 
empiricism.  We  can  do  nothing  more  than  show,  as  has 
been  done,  its  unreasonableness  and  the  precarious  and  con- 
tradictory and  disappointing  character  of  its  results.  We 
can  only  point  out  how  far  it  falls  below  the  standard  of 
action  to  which  practitioners  of  medicine  should  hold  them- 
selves, and  how  unworthy,  in  our  judgment,  such  methods 
are  of  reasoning  and  conscientious  men. 

The  second  class  accept  our  definition  of  the  requirements 
of  a  sound  prescription,  and  our  statement  'of  the  obligation 
of  scientific  men  to  abide  by  natural  laws.  But  they  claim 
that  alternation  does  not  necessarily,  as  we  have  maintained, 
contravene  the  requirements  of  such  a  prescription ;  and 
they  claim  that  there  are  certain  established  principles  in 
accordance  with  which  we  may,  with  scientific  accuracy, 
determine  when  and  how  to  alternate.  This  class  defend 
alternation  "on  principle."  As  the  former  class  comprises 
some  of  our  most  conscientious  and  estimable  colleagues,  so 
does  the  latter  embrace  many  of  the  most  gifted  and  learned 
of  our  school.  Their  opinions  are  worthy  of  the  most 
earnest  and  respectful  consideration. 

We  have  previously  stated  that  some  who  defend  alter- 
nation on  principle  designate  by  that  name  methods  which, 
we  think,  ought  not  to  be  so  called,  and  which  we  do  not 


ALTERNATION   OF   REMEDIES.      NO.    2.  187 

find  fault  with ;  as,  for  example,  Dr.  Coxe  ;  likewise  Dr. 
Drysdale,  in  so  far  as  his  definition  is  concerned.  Their 
methods  do  not  always,  of  necessity,  conflict  with  the  require- 
ments of  a  sound  prescription.  There  are  still  other  pro- 
cedures, called  "  alternation,"  but  which  are  not  always 
necessarily  liable  to  the  objections  urged  against  "  alter- 
nation," properly  so  called,  as  we  have  defined  it  (a  priori). 

The  occurrence  of  complications,  and  especially  of  trau- 
matic complications,  such  as  a  burn  of  the  hand,  during  the 
course  of  a  pneumonia — a  contused  vulva  simultaneously 
with  a  milk  fever,  are  mentioned  by  Dr.  Drysdale,  as 
instances  which  may  require  alternation ;  as,  for  example, 
Urtica  urens  to  the  burned  hand,  while  Phosphorus  is  being 
given  internally  for  the  pneumonia,  and  Arnica  to  the 
vulva,  while  Aconite  is  given  for  the  milk  fever. 

Now,  of  such  cases  as  these  it  might  perhaps  be  properly 
said,  that  they  do  not  come  under  the  scope  of  our  inquiry, 
inasmuch  as  the  burn  and  the  contusion  might  be  regarded 
as  purely  local,  and  not  at  all  constitutional  affections,  and 
the   respective   applications  might  be  viewed   in  the  same 
light,  and  as   not  capable,  when  thus  used,  of  affecting  the 
general  system,  and  of  thus  being,  in  fact,  alternated  with 
the  remedy    which  the  patient   is   taking  internally.     But, 
waiving  this  reply,  we  may  say  that  the   teaching  of  our 
own  experience  is,  that,  in  such  cases  as  these,  the  best  way 
is  to  follow  the  one  great  rule  which  governs  homeopathic 
prescription  ;  after  the  occurrence  of  the  complication,  collect 
and  scrutinize  the  patient's  symptoms  anew.     If  the  burn 
shall  have  been  so  slight  as  to  make  no  impression  on  t 
general  system,  to  produce  no  modification  in  the  symptc 
of  the    previously   existing   pneumonia,   then   there 
reason  for  doubting  that  simple  protection  from  the  atn 
pheric  air  will  be  all  that  is  needed  in  the  way  of 
for  the  burn. 

If,  on  the  other  hand,  the  burn  have  been  of  a  ser 
character,  so  as  to  produce  constitutional  disturbance,  it  will 


1 88  ALTERNATION    OF   REMEDIES.      NO.    2. 

assuredly  have  modified  the  symptoms  of  the  pneumonia, 
and  we  shall  perhaps  find,  on  taking  the  aggregate  of 
the  symptoms  again,  that  some  other  remedy  than  phos- 
phorus is  now  indicated  to  meet  the  new  state  of  things 
resulting  from  the  pneumonia  and  the  shock  of  the  burn 
combined,  and  that  this  new  remedy  will  meet  both  troubles. 
For  it  must  not  be  hastily  assumed,  as  Dr.  Drysdale  seems 
inclined  to  intimate,  that  Urtica  urens  locally  applied  is 
always  the  best  (or  a  good)  remedy  for  burns.  They  are 
often  (at  least)  best  treated,  as  Boenninghausen  has  shown, 
by  an  internal  remedy.  Singularly  enough,  it  once  chanced 
to  myself  to  meet  the  complication  which  Dr.  Drysdale  here 
supposes.  The  burn  was  severe,  and  the  effect  of  the  shock 
so  modified  the  symptoms  of  the  pneumonia  that  the  result- 
ing aggregate  of  symptoms  called  unmistakably  for  Arseni- 
cum,  which  was  given  with  most  gratifying  results,  as 
regards  both  pneumonia  and  burn.  The  same  may  be  said 
of  the  application  of  Arnica  to  contused  vulva.  Indeed, 
there  is  too  great  haste  among  us  to  recur  to  topical 
applications. 

The  second  "  principle "  upon  which,  according  to  Dr. 
Drysdale,  "the  practice  of  alternation  rests,"  is  "the  main- 
taining the  susceptibility."  Dr.  Drysdale  says  :  "  In  disease 
we  generally  find  that  the  susceptibility  to  the  homoeopathic 
remedy  is  present  from  the  nature  of  the  case,  and  our  great 
object  should  be  to  manage  the  doses  and  repetitions  so 
that  it  shall  not  be  exhausted  before  the  natural  period 
essential  for  a  cure.  This  unfortunately,  however,  not  un- 
frequently  happens,  in  spite  of  varying  the  dilutions  or 
originally  having  chosen  the  best.  In  this  case  the  plan  has 
been  adopted  of  interposing  doses  of  another  remedy  as 
nearly  as  possible  homoeopathic  to  the  case.  This  must,  of 
course,  be  an  antidote,  but,  as  in  the  case  of  natural  disease, 
it  may  tend  to  revive  the  susceptibility  to  the  first  remedy. 
*  *  *  Without  the  use  of  occasional  alternation  and 
intermediate  remedies,  we  should  be  almost  deprived  of  the 


ALTERNATION    OF    REMEDIES.       NO.    2.  189 

use  of  a  large  class  of  serviceable  remedies  in  chronic  disease, 
such  as  Opium  in  constipation,  Lobelia,  Lactuca,  etc.,  in 
asthma,  Coffea  and  Aconite  in  neuralgia,  etc." 

This  question  of  the  propriety  of  alternating  for  the  pur- 
pose of  reviving  the  exhausted  susceptibility  may  be  treated 
in  much  the  same  way  as  the  question  of  alternating  to  meet 
complications.  When  we  have  a  case  under  treatment,  we 
shall  not  be  led  to  suspect  an  exhaustion  of  susceptibility, 
except  by  a  change  in  the  symptoms.  Now,  if  the 
symptoms  have  changed,  this  very  change  furnishes  us  the 
basis  for  a  new  prescription.  Why  shall  we  not  at  once 
proceed,  in  accordance  with  the  great  rule  of  our  art,  to 
select  a  new  remedy  corresponding  with  these  changed 
symptoms  ?  Why  should  we  prefer,  to  this  certain  method, 
the  pathological  hypothesis  that  the  susceptibility  to  a  rem- 
edy which  we  have  assumed  to  be  suited  to  the  disease  has 
become  exhausted  and  needs  a  stimulant  ?  This  hypothesis 
may  be  correct,  but  can  never  be  a  certain  basis  for  practice. 

But  let  us  take  an  example  :  Cases  of  dysentery  not  unfre- 
quently  occur  in  which  Nux  vomica  or  Mercurius  seemed  in 
the  beginning  to  be  very  clearly  indicated.  The  patient  im- 
proves for  a  few  days  under  the  use  of  one  of  these  remedies, 
and  then  ceases  to  improve.  On  a  careful  scrutiny  of  the 
case  it  appears  that  the  prominent  characteristic  symptoms 
(most  of  them  subjective,  of  course)  have  disappeared  or  be- 
come obscure.  Even  the  evacuations  have  ceased  to  be 
characteristic  of  any  remedy.  The  entire  system  is  dull, 
languid,  unimpressible.  In  such  a  case  as  this,  we  are  told 
that  the  susceptibility  of  the  patient  has  become  exhausted; 
that  a  few  doses  of  Opium  will  arouse  it  so  that  it  will  again 
respond  to  the  appropriate  remedy,  and  will  be  cured. 

As  a  matter  of  fact  we  know  this  treatment  does  succeed 
in  many  cases,  but  the  rationale  of  the  process  is  by  no 
means  satisfactory  to  us.  And  this  is  not  a  solitary  instance 
of  a  successful  practice  following,  through  good  luck,  from  a 
very  faulty  theory.  If  we  analyze  the  case  described  we 


190  ALTERNATION   OF   REMEDIES.      NO.    2. 

shall  find,  that  when  the  patient  ceases  to  improve  under  the 
Nux  or  the  Mercurius  which  was  first  given,  his  symptoms 
changed  in  such  a  way  that  their  totality  furnished  a  satisfac- 
tory indication  for  Opium,  and  a  capable  prescriber  would 
accordingly  have  selected  Opium  and  cured  his  case,  even 
though  the  notion  of  "  exhausted  susceptibility  "  had  never 
entered  his  head.  Simple  adherence  to  the  great  principle 
of  homoeopathic  prescribing,  viz.,  that  each  prescription  is  to 
be  founded  on  a  new  collection  of  the  symptoms  and  a  new 
comparison  of  them  with  the  Materia  Medica,  leads  to  suc- 
cess in  all  such  cases,  without  the  intervention  of  any  patho- 
logical hypothesis  whatever  ;  at  the  same  time  it  excludes  all 
danger  of  appearing  to  sanction  the  bad  habit  of  alternation. 
As  regards  the  use  of  Opium  for  constipation  in  chronic 
diseases,  and  Coffea  in  neuralgia,  these  being  used  as  inter- 
mediate or  alternated  remedies,  they,  like  topical  applica- 
tions in  traumatic  complications,  are  much  abused,  and  often 
altogether  needless  if  not  hurtful.  A  single  example  will 
illustrate  this  point :  A  patient,  not  long  ago,  while  under  a 
friend's  treatment  came  under  my  observation.  Her  symp- 
toms corresponded  exceedingly  well  with  those  of  Conium 
maculatum.  It  was  a  chronic  disease  of  long  standing. 
She  had  troublesome  constipation,  which  was  sometimes  so 
bad  that  it  seemed  to  completely  neutralize  the  good  effect 
which  Conium  was  evidently  producing.  A  dose  or  two  of 
Opium1"50  would  relieve  the  constipation,  and  the  patient 
would  seem  for  a  while  to  improve  again  under  the  Conium. 
This  might  be  called  an  illustration  of  what  Dr.  Drysdale 
refers  to  as  the  necessity  for  alternated  or  intermediate 
remedies  in  either  "complications  of  chronic  diseases,"  or 
"exhausted  susceptibility."  It  was  not,  however,  satisfac- 
tory to  my  friend,  nor  to  myself.  He  could  not  regard  the 
regularly  recurring  constipation  as  a  foreign  complication. 
Believing  in  the  unity  of  disease,  he  looked  upon  it  as  an 
integral  portion  of  that  patient's  sickness  and  did  not  rest 
contented  until  he  had  found  a  single  remedy  which  covered 


ALTERNATION   OF   REMEDIES.      NO.    2.  191 

both  the  symptoms  to  which  Conium  corresponded  and  the 
constipation  besides.  This  remedy  was  Alumina,  under 
which  the  bowels  became,  and  they  have  remained,  perfectly 
regular.  The  patient's  improvement,  in  other  respects,  was 
all  that  could  be  desired.  In  this  case,  as  in  most  cases 
narrated  of  cures  by  alternation,  the  Opium  and  Conium,  in 
alternation,  seemed  to  work  very  well,  and  promised  to 
effect  a  cure  in  the  fullness  of  time.  I  doubt  not  that  if, 
to  all  the  other  histories  of  cures  by  alternation,  a  sequel 
could  be  written,  it  would  be  found  that  each  of  these  cases 
has,  in  the  Materia  Medica  (actual  or  future),  its  own  par- 
ticular Alumina,  which  would  effect  a  cure  in  as  few  days, 
as  the  most  sanguine  alternate  would  expect  to  accomplish 
it  in  months. 

Having  thus  shown  our  belief  that  the  alternation  which 
Dr.  Drysdale  defends,  for  the  purposes  of  "  meeting  compli- 
cations," and  of  "awakening  susceptibility,"  is  not  alter- 
nation a  priori,  not  alternation  properly  so  called,  but  is 
compatible  with  sound  doctrine,  although  explained  by  the 
use  of  unsound  pathological  hypotheses,  we  shall  pass,  next, 
to  the  two  general  principles  on  which  alternation,  properly 
so  called,  is  really  based  and  defended. 

Before  proceeding  further  in  the  discussion  of  the  subject 
of  Alternation,  let  us  briefly  recapitulate  the  positions 
already  taken. 

I.  We  have  assumed  that  the  propriety  of  Alternation  can 
be  argued  about  only  by  those  who  regard  the  practice  of 
medicine  as  an  art  based  upon  scientific  principles,  by  refer- 
ence to  which  it  is  to  be  regulated  and  exercised.  We  have 
not  considered  it  possible  to  discuss  the  question  with  those 
who  make  their  practice  a  series  of  repetitions  of  individual 
experiences,  without  the  intervention  of  general  principles 
based  on  and  inferred  from  a  large  number  of  individual 

instances. 

No  discussion  can  be  sustained  with  this  class  of  practi- 
tioners, for  the  reason  that  argument  involves,  in  its  very 


192  ALTERNATION   OF    REMEDIES.       NO.    2. 

nature,  an  appeal  to  principle  and  the  exercise  of  reason. 
When,  consequently,  an  advocate  of  Alternation  objects  to 
our  condemnation  of  his  method,  that  he  regards  the  subject 
from  a  practical  point  of  view,  while  we  persist  in  ignoring 
the  practical,  and  in  looking  only  at  the  question  as  one  of 
science,  we  feel  driven  to  the  conclusion  that,  if  excluded 
from  the  ground  of  scientific  principle,  we  have  no  ground 
left  on  which  to  stand  for  the  discussion  of  this  or  of  any 
question  of  medical  practice  ;  and  further  than  this  we  have 
nothing  to  say. 

2.  We   have   stated   our   belief  that    many   writers    have 
defended,    under   the    name    of  ALTERNATION,  modes    of 
practice   which    are,    in    our   opinion,    not   properly   called 
Alternation,  and  which  certainly  are  not  open  to  the  objec- 
tions that  we  entertain  to  what  we  have  defined  as  ALTER- 
NATION, properly  so  called. 

3.  Defining  Alternation,   as    we   understand   it,  we  have 
taken  occasion  to  state  the  requirements  of  a  sound  homoeo- 
pathic prescription,  requirements  which  cannot  be  met  by 
the  process  of  Alternation. 

We  come  now,  in  conclusion,  to  consider  certain  state- 
ments of  principles  by  which  Alternation,  as  we  define  it, 
has  been  sought  to  be  justified  and  defended. 

Dr.  Coe  !  states :  "  It  is  an  established  principle  in  Homoe- 
opathy, demonstrated  by  drug-proving  and  clinical  experi- 
ence, that  each  drug  has  its  own  specific  sphere  and  manner 
of  action,  hence  that  each  remedy  acts  in  a  particular 
manner  upon  a  particular  organ  or  tissue,  or  upon  a  particu- 
lar set  of  organs  or  tissues.  Another  recognized  principle 
in  Homoeopathy  is,  that  attenuated  remedies  act  on  the 
system  only  by  virtue  of  their  homceopathicity  to  the  disease 
by  which  the  system  is  at  the  time  affected ;  hence  they  are 
inert  when  taken  by  persons  in  health."  [One  of  our  best 
provings  of  Natrum  muriaticum  on  the  healthy  was  made 
by  Dr.  Wurmb  with  the  jot/i  decimal  dilution  /]  *  * 

1  American  Homoeopathic  Revieiu,  vol.  v.,  p.  447. 


ALTERNATION   OF   REMEDIES.      NO.    2.  193 

"  But,  supposing  I  find  no  single  remedy  that  will  complete 
the  picture  [corresponding  to  the  picture  of  the  disease]  ; 
some  part  is  still  defective — it  either  wants  a  head,  a  body, 
or  a  limb,  what  am  I  to  do  ?  What  I  do  is  this :  I  finish 
out  the  picture  with  something  that  will  complete  it.  If  the 
head  symptoms  are  unmistakably  Aconite  symptoms,  and 
nothing  else,  the  chest  symptoms  unmistakably  Bryonia  symp- 
toms, and  nothing  else,  and  the  symptoms  of  the  lower  limbs 
unmistakably  Rhus  symptoms,  and  nothing  else,1 1  can  finish 
my  picture  in  no  other  way,  nor  can  any  one  else.  *  * 
But  the  single  remedy  objector  says,  one  of  my  medicines 
will  modify  the  action  of  the  other  in  such  a  manner  that  I 
cannot  rely  upon  their  doing  what  their  pathogenesis  would 
indicate.  I  think  he  is  mistaken.  If  attenuated  medicines 
only  act  homceopathically,  as  we  all  hold,  only  act  ^lpon 
those  organs  and  tissues  which  are  affected  by  disease  in  a 
manner  similar  to  the  drug  affection,  then  my  Aconite, 
Bryonia  and  Rhus  each  goes  to  its  own  place,  and  performs 
its  own  office,  without  interfering  or  being  interfered  with 
by  the  others." 

Dr.  Drysdale  appears  to  agree  with  Dr.  Coe,  for  he  says  :2 
"  There  are,  therefore,  no  a  priori  physiological  grounds  for 
doubting  that  two  medicines,  whose  physiological  spheres 
are  sufficiently  dissimilar,  can  display  their  effects  without 
interference,  when  given  at  intervals.  Let  us  apply  this  to 
the  treatment  of  complications  in  disease,  and  by  this  we  may 
chiefly  understand  those  symptoms  or  morbid  states  that  are 
not  necessarily  dependent  on  one  common  proximate  cause, 
but  are  connected  merely  by  their  happening  to  co-exist 
in  the  same  individual."  [We  protest  against  this  cool 

1  Humane  capiti  cervicem  pictor  equinam 
Jungere  si  velit,  et  varias  inducere  plumas 
Undique  collatis  membris,  ut  turpiter  atrum 
Desinat  in  piscem  mulier  formosa  superne, 
Spectatum  admissi  risum  teneatis,  amici  ? 

Horat.  Epiit.  ad  Pisones. 

*  Annals  of  British  Horn.  Society,  xvii.,  375- 
14 


194  ALTERNATION   OF   REMEDIES.      NO.    2. 

assumption  that  two  or  more  "  morbid  states  may  co-exist 
in  the  same  individual,"  connected  merely  by  their  acci- 
dental co-existence  !  ]  "  After  exposure  to  cold  we  may  be 
attacked  with  inflammation  of  the  nasal,  tracheal  or  bronchial 
mucous  membrane,  or  parenchyma  of  the  lungs  or  the  pleura 
or  the  parietes  of  the  chest  or  the  liver  or  peritoneum,  etc., 
according  to  the  specific  susceptibility  of  the  tissues  attacked ; 
and  each  of  these  diseases  may  exist  separately,  and  be 
attended  with  the  appropriate  essential  and  sympathetic 
symptoms  of  the  case.  In  such  cases  we  ought  properly  to 
rely  on  one  medicine,  which  may  be  reasonably  expected  to 
meet  the  specific  susceptibility  of  the  part  primarily  affected. 
But,  on  the  other  hand,  from  exposure  to  the  same  cause, 
inflammation  may  be  set  up  in  several  of  those  tissues  at  the 
same  time,  and  thus  several  trains  of  morbid  symptoms  set 
up  that  have  no  necessary  [  would  the  author  have  better 
expressed  his  real  meaning  if  he  had  said,  'pathologico-ana- 
tomical  ? '  ]  connection,  except  that  of  occurring  in  the  same 
individual.  In  that  case,  how  can  any  one  medicine  be 
homoeopathic  to  the  case  which  does  not  show  its  specific 
relation  to  all  those  different  tissues  in  health  ?  * 

"  Dr.  Gate  also  brings  forward  inflammation  of  the  mucous 
coat  of  the  colon.  When  it  extends  to  the  peritoneal  coat 
of  the  gut,  he  gives  Mercurius  corrosivus  in  alternation  with 
Sulphur,  corresponding  to  their  specific  action  on  their 
(these)  different  tissues.  Also  in  inflammation  of  the  mem- 
branes of  the  brain,  threatening  effusion,  he  finds  Bryonia, 
alternated  with  Hellebore,  more  efficacious  than  either 
singly.  But  this  is  already  recognized  in  Homoeopathy, 
without  stepping  into  the  doubtful  regions  of  pathology." 

In  discussing  these  statements  we  desire  to  use  great  mod- 
eration of  expression,  conceding  freely  that  they  involve 
questions  of  pathology  and  pathogenesy,  of  which  our 
knowledge  is  only,  and  perhaps  can  be  only,  proximative, 
and  concerning  which,  instead  of  absolute  facts,  we  have 
only  probabilities. 


ALTERNATION   OF   REMEDIES.      NO.    2.  195 

Among  those  who  discuss  questions  of  medical  philoso- 
phy may  be  distinguished  two  characters  of  mind,  corre- 
sponding to  similar  classes  among  intellectual  philosophers — 
the  analytic  and  the  synthetic. 

The  tendency  of  the  one  class  is  to  divide  an  independent 
group  of  phenomena,  such  as  a  sick  man  or  a  drug-proving 
presents,  into  elements  each  one  of  which  it  inclines  to 
regard  as  independent  of  the  others.  To  the  researches  of 
this  character  of  mind  we  owe  our  knowledge  of  Histology, 
both  physiological  and  pathological,  and  much  else  that  is  of 
inestimable  value  in  medical  science.  The  same  disposition 
being  carried  into  clinical  investigation,  the  symptoms  of  the 
sick  man  have  been  analyzed  into  the  perversions  of  function 
of  the  various  organs,  and  the  alterations  of  the  different  tis- 
sues of  the  body,  as  well  as  the  formation  of  tissues  not 
found  in  the  healthy  body.  As  a  result,  we  have  the  precious 
sciences  of  Pathology  and  Pathological  Anatomy. 

Based,  as  these  analyses  are,  upon  material  changes  of 
structure  and  of  product,  the  danger  to  which  those  who 
engage  in  them  are  liable  is  this :  that  having  their  attention 
exclusively  directed  to  material  changes,  or  to  visible  and 
tangible  results  of  material  changes,  they  overlook  two 
points  to  which  it  is  equally  important  that  observations 
should  be  directed. 

ist.  That  inasmuch  as  healthy  tissues  exist,  and  healthy 
functions  are  performed,  by  virtue  of  an  imponderable  force 
called  for  lack  of  a  better  name,  "  vital  force,"  and  which 
is  inherent  in  each  tissue,  and  gives  to  it  its  specific  proper- 
ties, there  must  have  been  a  change  in  this  force  preceding 
every  material  change. 

2d.  That  this  force,  though  it  seem  to  impart  to  each  tissue 
and  organ  a  susceptibility  to  stimulus  peculiar  to  that  tissue, 
yet  so  pervades  and  vivifies  the  entire  organism,  as  to  give 
rise  to  what  is  known  as  sympathy — a  property  of  living 
organisms,  by  virtue  of  which  there  results,  from  the  serious 
modification  of  any  function  or  alteration  of  any  tissue,  a 


196  ALTERNATION    OF    REMEDIES.       NO.    2. 

corresponding  and  definite  modification  of  most  if  not  all  of 
the  functions  of  the  body,  and  an  alteration  of  at  least  many 
of  the  tissues.  It  is  by  virtue  of  this  property  that  each 
individual  man  is  a  living  unit,  and  not  a  collection  of 
independent  monads,  which  merely  chance  to  co-exist  in 
one  human  form. 

No  physical  research  can  detect  this  vital  force,  nor  reveal 
the  nature  or  modus  operandi  of  this  function  of  sympathy, 
and  hence  it  happens  that  those  whose  minds  incline  to  rest 
upon  the  data  of  physical  analysis  are  prone  to  overlook 
them,  or,  even  though  they  admit  them  in  their  philosophy, 
yet  to  practically  ignore  or  underestimate  them.  From  this 
tendency  results  a  disposition  to  regard  the  proximate  cause 
of  disease — that  is  to  say,  the  material  change  of  tissue  and 
product — as  the  essence  of  the  disease,  forgetting  the  modifi- 
cation of  vital  force,  which  must  have  preceded  and  been  the 
occasion  of  this  proximate  cause, — and  a  further  disposition 
to  look  upon  the  alteration  of  function  and  tissue  of  each 
organ  or  system  of  the  body  as  a  separate  disease,  thus 
easily  admitting  the  idea  of  the  co-existence  of  several 
independent  diseases  and  of  complicating  diseases  without 
number. 

From  the  stand-point  of  this  class  of  mind  it  is  not  easy  to 
perceive  the  mutual  relations  and  interdependencies  of  appar- 
ently remote  groups  of  symptoms — such,  for  example,  as 
ulceration  of  the  cervix  uteri  and  chronic  conjunctivitis, 
which,  if  they  co-exist  in  any  patient,  would  be  likely  to  be 
regarded  as  independent  diseases,  and  to  be  treated  by 
independent  courses  of  medication  ;  whereas,  in  fact,  they 
are  so  intimately  connected  that  they  are  best  treated  by  a 
single  remedy. 

Nothing  is  farther  from  our  purpose  than  to  make  light  of 
Pathology,  which,  as  an  aid  in  the  investigation  of  disease, 
is  of  inestimable  value.  It  is  evident,  however,  that  Hahne- 
mann  was  right  in  warning  his  disciples  against  making  it 
the  basis  of  medical  practice.  Its  investigations  cannot,  in 


ALTERNATION   OF   REMEDIES.      NO.    2.  197 

the  nature  of  things,  go  beyond  material  changes.  Yet  dis- 
ease begins  in  dynamic  changes ;  and  the  connections  of 
different  groups  of  symptoms  are  dynamic,  and  beyond  the 
reach  of  physical  research. 

And  then,  even  where  the  subject  is  material  and  amen- 
able to  physical  research,  to  base  the  prescription  upon  a 
determination  of  the  organ  or  tissue  affected  by  the  drug 
and  by  the  disease,  is  to  go  backward  from  the  certainty 
afforded  by  a  comparison  of  the  symptoms  to  the  uncertainty 
of  a  double  hypothesis.  For,  as  in  the  cases  supposed  by  Dr. 
Drysdale,  we  have  first  to  assume  that  the  symptoms  pro- 
duced on  the  healthy  subject  by  Mercurius  corrosivus  and 
by  Sulphur  respectively,  show  that  the  one  of  these  drugs 
acts  especially  on  the  mucous  membrane  of  the  colon,  and 
the  other  on  the  serous  covering  of  it ;  and,  secondly,  we 
must  assume  that,  in  the  patient  before  us,  the  inflammation 
which  began  in  the  mucous  membrane  has  extended  to  the 
serous  membrane ;  and  on  this  double  assumption  our 
alternation  is  to  be  based  and  defended.  Suppose,  that  in 
its  progress  from  within  outward,  the  disease  also  affected 
the  muscular  coat — should  we  give  Nux  vomica  also  ?  Or 
the  glands  likewise  —  shall  we  give  a  fourth  remedy,  say, 
Rhus  ?  Then  the  vascular  system  of  the  gut  is  probably 
simultaneously  affected  — would  this  call  for  Hamamelis,  or  for 
Aconite  for  the  arteries  and  Hamamelis  for  the  veins  ?  Here 
we  should  have  six  remedies  to  be  alternated,  the  selection 
of  each  being  based  upon  its  "specific  relation  to  the  tissue" 
affected,  etc.,  etc.  Now,  what  is  all  this  but  a  revival  of  the 
old  method,  against  which  Hahnemann  so  earnestly  pro- 
tested, of  prescribing  upon  the  basis  of  an  hypothesis  of  the 
nature'  and  seat  of  the  disease— an  utter  throwing  overboard 
of  the  whole  system  of  Inductive  Philosophy,  as  so  logically 
and  so  successfully  applied  to  medical  practice  by  Hahne- 
mann ? 

It  may  be  worth  our  while  to  dwell  for  a  few  moments 
longer  on  this  very  important  branch  of  the  subject,  for  it  is 


198  ALTERNATION    OF   REMEDIES.      NO.    2. 

a  point  on  which  very  many  practitioners  have  gone  astray. 
Indeed,  we  have  seen  an  attempt  to  reconstruct  our  entire 
Materia  Medica  Pura,  on  the  basis  of  the  specific  action  of 
the  drugs  respectively  upon  certain  organs  and  tissues  of 
the  body — almost  all  symptoms  not  anatomically  expli- 
cable being  excluded  (the  so-called  "  American  Materia 
Medica"). 

The  statement  of  a  "  general  principle,"  which  we  quoted, 
viz.,  "  It  is  an  established  principle  in  Homoeopathy,  demon- 
strated by  drug-proving  and  clinical  experience,  that  each 
drug  has  its  own  specific  sphere  and  manner  of  action, 
hence (\]  that  each  remedy  acts  in  a  particular  manner  upon 
a  particular  organ  or  tissue,  or  upon  a  particular  set  of  organs 
or  tissues,"  contains,  it  seems  to  us,  a  fallacy.  While  we 
admit,  of  course,  that  each  drug  has  its  own  specific  sphere 
and  manner  of  action,  it  does  not  seem  to  us  that  this  is 
equivalent  to  saying  that  each  drug  acts  in  its  peculiar  way 
on  "a  particular  organ  or  tissue,  or  a  particular  set  of  organs 
and  tissues,"  leaving  —  (for  this  is  implied  in  the  statement, 
as  the  rest  of  the  article  from  which  we  quote  shows)  —  leav- 
ing the  other  organs  and  tissues  of  the  body  wholly 
tinaffected  by  the  action  of  the  drug  or  disease,  as  the  case 
may  be.  Yet  it  is  necessary  to  assume  this  fallacy,  in  order 
to  justify  the  practice  of  alternation. 

On  the  contrary,  we  have  never  met  with,  and  we  do  not 
believe  in  the  possible  existence  of,  a  case  of  sickness  in 
which,  as  adduced  by  Dr.  Coe,  the  head  could  be  affected  in 
one  way,  so  as  to  unmistakably  call  for  Aconite,  and  yet  no 
organ  of  the  body  show  Aconite  symptoms ;  while  at  the 
same  time  the  chest  presented  exclusively  Bryonia  symp- 
toms, and  the  extremities  Rhus  symptoms.  The  uniform 
tendency  of  our  own  practical  experience  goes  to  satisfy  us 
that,  if  any  concrete  case  should  present  clear  characteristic 
Aconite  symptoms  in  any  portion  of  the  body,  then  not  only 
would  symptoms  of  disease  be  found  in  most  of  the  other 
important  organs  or  systems,  but  that  these  systems  would 


ALTERNATION   OF   REMEDIES.      NO.    2.  199 

present  more  or  less  well  defined  characteristics  of  Aconite : 
or  even  should  they  not   present  characteristics  which  we 
recognize  as  those  of  Aconite,  the  symptoms  would  never- 
theless speedily  disappear  under  the  use  of  Aconite,  if  that 
drug  were  clearly  indicated  by  characteristic  symptoms  in 
the  other  organs.     So  abundantly  has  our  experience  con- 
firmed this  view,  that  if  we  find  clear  characteristics  of  any 
drug  in  the  symptoms  of  any  organ  of  the  body,  no  matter 
what  symptoms   may  be  presented  by  other  parts    of  the 
body,  and  no  matter  how  little  these  latter  symptoms  may 
seem  to  indicate  this  same  drug,  we  never  dream  of  alterna- 
ting remedies.     We  are  confident  that  a  remedy  which  is 
clearly  indicated  by  characteristic  symptoms,  though  they  be 
but  few    in  number,    will    cover   the  whole    case,  and    will 
remove  the  entire  disease.     Nor  do  we,  as  is  assumed  by  the 
alternators,  expect  to  accomplish  by  "succession"  what  they 
aim  to  effect  by  Alternation.     We  so  thoroughly  believe  in 
the  unity  of  disease  as  to  be  confident,   that,   in   however 
many    organs    and  tissues  morbid    symptoms  may  present 
themselves,  they  still  spring  from  and  depend  upon  one  and 
the  same  unknown  and  inscrutable  cause,  just  as  the  multifari- 
ous symptoms  of  a  drug-proving  depend  upon  the  one  cause, 
viz.,  the  drug;  and  that  though  the  characteristic  symptoms 
which  furnish  the  indication  for  the  remedy  may  be  observed 
only  in  the  symptoms  of  one  organ  or  system,  yet  the  symp- 
toms of  all  the  rest  of  the  body  will  be  equally  controlled  by 
the  action  of  this  remedy.      It  is  remarkable,  however,  to 
how  great  an  extent,  if  we  observe  carefully  and  intelligently, 
we  may  recognize,  in  the  various  groups  of  symptoms  affect- 
ing the  various  organs  of  the  patient,  the  characteristic  mode 
of  action,  and  the  conditions  of  that  remedy,  the  characteris- 
tic indications  for  which  we  find  in  some  one  organ  alone  of 
the  patient ! 

The  tendency  of  the  second  of  the  classes  of  minds  into 
which  we  divided  medical  philosophy  is  to  synthesis.  They 
are,  perhaps,  in  danger  of  underestimating  those  material 


200  ALTERNATION   OF   REMEDIES.      NO.    2. 

changes  of  tissue  which  are  the  proximate  cause  of  disease, 
because  they  are  intent  upon  observing  and  tracing  out  that 
perversion  of  the  vital  force  which  must  have  preceded  and 
induced  all  the  organic  and  material  changes  which  the  case 
presents,  and  which  perversion  they  regard  as  essentially  the 
disease  itself.  They  study  this  perversion  in  its  various 
manifestations,  viz.,  the  symptoms.  They  do  not  seek  to 
analyze  these  groups  of  symptoms,  for  the  purpose  of  form- 
ing a  theory  respecting  the  tissues  affected,  so  as  to  select  a 
remedy  which  affects,  as  they  suppose,  identical  tissues,  and 
in  the  same  way.  They  do  not  thus  admit  hypothesis  into 
their  method.  They  study  the  groups  of  symptoms  to  get 
at  their  peculiarities  and  conditions.  Profoundly  impressed 
with  the  intimate  connection  of  all  parts  of  the  body,  through 
the  all-pervading  Vital  Force  (whatever  it  may  be),  and  with 
the  fact,  observed  every  day,  that  change  of  function  in  one 
part  of  the  body  speedily  brings  about  corresponding  changes 
in  almost  every  other  part,  they  seek,  by  the  light  of  one 
group  of  symptoms,  to  find  in  the  patient  other  and  corre- 
sponding groups.  In  these  investigations  Physiology  and 
Pathology,  which  teach  the  relations  and  mutual  dependen- 
cies of  different  organs,  are  of  inestimable  value,  enabling  the 
student  to  find  in  remote  organs  parallel  groups  of  symp- 
toms; the  characteristic  which  determines  his  choice  of  a 
remedy  being  often  in  an  organ  very  remote  from  that  to 
which  his  attention  was  first  called  as  being  the  seat  of 
disease.  Having  thus  been  led,  by  his  philosophy,  to  collect 
the  various  groups  of  symptoms  presented  by  the  entire 
body,  as  constituting  one  single  disease,  the  practitioner 
surveys  this  collection  in  search  of  the  characteristic  symp- 
tom, or  group  of  symptoms  which  shall  point  to  his  remedy. 
Ninety  of  the  symptoms  might  be  found  among  many  reme- 
dies, ten  perhaps  may  be  peculiar  to,  and  characteristic  of,  a 
single  drug.  This  he  selects,  without  hesitation,  as  his 
remedy  for  the  entire  malady  of  that  patient. 

Suppose  the  patient  to  have  taken  cold,  and  to  present, 


ALTERNATION   OF   REMEDIES.      NO.    2.  2OI 

in  consequence,  a  malady  which,  anatomically,  is  made  up 
of  a  pneumonia  and  hepatitis.  It  is  all  well  enough,  and 
doubtless  important  for  the  purposes  of  diagnosis  and  prog- 
nosis, to  make  this  pathologico-anatomical  analysis  of  the 
case.  But  when  we  come  to  regard  the  case  from  the 
stand-point  of  Therapeutics,  we  are  not  surely  to  follow  the 
plan  which  Dr.  Drysdale  seems  to  sanction,  viz.,  to  look 
among  the  drugs  which  are  shown  by  provings  to  act  on  the 
tissues  of  the  lung,  and  select  the  best  from  among  them, 
and  then  to  look  among  remedies  which  act  on  the  tissues 
of  the  liver,  and  select  the  best  from  among  these  remedies, 
and  to  alternate  the  two  thus  selected.  What  if,  as  would 
be  likely  in  such  a  case,  the  pleura,  likewise,  were  inflamed  ? 
Should  we  have  a  third  remedy?  Or  the  kidneys  also? 
Should  we  have  a  fourth  ?  "Quousque  tandem  -  " 

On  the  contrary,  we  should  collect  the  various  groups  of 
symptoms,  as  well  those  from  which  the  Pathologist  infers 
that  the  tissue  of  the  lung  is  affected,  as  those  from  which  he 
infers  that  the  tissue  of  the  liver  is  affected.  All  other 
symptoms  likewise  would  be  gathered.  We  should  examine 
these  symptoms,  in  the  manner  so  often  described,  for  the 
purpose  of  finding  in  them  the  peculiar  characteristics  of 
some  particular  drug.  In  thus  dealing  with  the  case,  we 
should  have  this  advantage  over  the  Pathologist,  that  whereas 
his  inferences  may  lead  him  astray,  since  the  lung  tissue 
may  not  be  affected  as  he  thinks  it  is—  and  likewise  the 
tissue  of  the  liver  —  we,  on  the  other  hand,  taking  into 
account  only  the  obvious  symptoms,  avoid  at  least  one  very 
patent  source  of  fallacy.  Our  own  experience  has  alto- 
gether misled  us  if  we  do  not  find,  in  the  case  supposed, 
that  if  the  lung  symptoms  give  us  characteristic  indications 
for  a  remedy,  the  liver  symptoms  not  only  will  not  contradict 
this  indication  by  affording  one  for  some  other  remedy,  but 
they  will  corroborate  the  indication,  so  as  to  give  us  no  pre- 
text for  alternating. 

But  another  case  is  supposed,  viz.,  that  a  pneumonia  i 


lr  K  ' 


202  ALTERNATION    OF   REMEDIES.      NO.    2. 

present,  and  a  remedy  has  been  well  selected  for  it,  and  now 
a  hepatitis  supervenes  to  complicate  the  case.  Here,  we 
are  told,  is  a  new  disease,  which  can  have  nothing  to  do 
with  the  previously  existing  pneumonia,  and  which  must 
require  a  distinct  treatment,  in  the  way  of  alternation.  This 
is  in  no  way  different  from  the  complication  of  a  burn,  of 
which  we  have  already  spoken.  If  the  complication  is 
serious  enough  to  produce  constitutional  symptoms  (as  a 
hepatitis  would  surely  be),  it  would  always  (or  our  observa- 
tion has  uniformly  deceived  us)  modify  all  existing  symp- 
toms. For  example,  a  severe  burn  would  give  a  typhoid 
character  to  an  existing  pneumonia.  We  must  then  make  a 
new  collection  of  the  symptoms,  and  proceed  as  before  to 
select  a  remedy. 

Under  any  other  plan  —  if  we  are  to  select  our  remedy 
according  to  correspondence  of  known  drug-action  and 
disease-action  upon  the  tissues  of  the  body — not  only  are 
we  liable  to  errors  already  pointed  out,  but  our  scope  is 
wonderfully  restricted.  How  could  we  find  remedies  for 
changes  of  structure,  such  as  we  can  never  expect  to  see  in 
drug-provings,  such  as  cancer  and  heterologous  growths  of 
all  kinds  ?  How,  for  affections  which  do  not  depend  on  or 
involve  any  definite  known  change  of  tissue,  as  intermittent 
fever,  epilepsy,  hysteria,  and  the  host  of  chronic  ailments  ? 

The  two  principles  on  which  alternation  has  been  sought 
to  be  defended  have  been  stated  as  follows : 

ist.  "Each  drug  has  its  own  specific  sphere  and  manner 
of  action ;  hence  that  remedy  acts  in  a  particular  manner 
upon  a  particular  organ  or  tissue,  or  upon  a  particular  set 
of  organs  or  tissues." 

2d.  "  Attenuated  remedies  act  upon  the  system  only  by 
virtue  of  their  homceopathicity  to  the  disease  by  which  the 
system  is  at  the  time  affected." 

The  artificial  disease  intentionally  produced  by  a  drug, 
and  the  natural  disease  which  results  from  the  usual  morbific 
predisposing  and  exciting  causes  may,  for  all  purposes  of 


ALTERNATION    OF   REMEDIES.      NO.    2.  203 

argument,  be  regarded  as  identical.  Principle  No.  I  might, 
therefore,  with  equal  propriety,  be  expressed  thus:  "A 
disease  has  its  own  specific  sphere  and  manner  of  action; 
hence  that  disease  acts  in  a  particular  manner  upon  a 
particular  organ  or  tissue,  or  upon  a  particular  set  of  organs 
or  tissues." 

A  corollary  of  this  proposition  is,  that,  inasmuch  as  the 
drug  and  the  disease  respectively  act  in  a  particular  manner 
and  upon  particular  organs  or  tissues,  they  leave  other 
organs  and  tissues  of  the  body  altogether  unaffected,  in  their 
normal  state  and  performing  their  healthy  functions,  and 
liable  to  be  themselves  attacked  by  some  other  disease, 
which  may  affect  them  in  its  own  particular  manner,  and 
may  run  a  simultaneous  and  independent  course. 

This  is  the  argument  for  alternation  which  is  constructed 
upon  these  principles :  a  certain  disease  affects  in  a  peculiar 
way  certain  organs  or  tissues  of  the  body,  leaving  the  other 
organs  and  tissues  in  the  fulfillment  of  their  normal  functions. 
Attenuated  medicines  may  be  administered  to  cure  this 
disease.  Attenuated  medicines  "  act  only  by  their  homoeo- 
pathicity  to  the  disease."  "They  are  inert"  so  far  as  action 
on  the  healthy  organs  or  tissues  is  concerned.  Homoeo- 
pathic medicines  act  only  where,  says  Dr.  Drysdale,  they 
find  that  preternatural  susceptibility  to  their  action,  which 
inheres  in  organs  or  tissues  diseased  in  a  manner  similar  to 
the  morbid  state  which  those  drugs  can  produce  on  the 
healthy. 

These  attenuated  medicines  then  may  be  given  for  the 
case  we  have  supposed.  They  will  act  upon  the  diseased 
organs  and  tissues,  but  will  not  affect  the  healthy  ones  at  all. 
Now,  then,  during  the  existence  of  this  disease,  which,  as 
stated,  affects  in  a  particular  manner  certain  organs  and 
tissues,  and  leaves  all  the  rest  undisturbed,  a  second  disease 
may  attack  the  individual  (may  we  call  one  who  may  be 
thus  divided  up  an  individual?)  acting  in  some  other  par- 
ticular manner,  upon  some  other  particular  organ  or  tissue. 


204  ALTERNATION    OF    REMEDIES.       NO.    2. 

To  meet  this  new  disease,  co-existent  with  the  original,  it 
is  affirmed  that  a  second  remedy  homoeopathic  to  it  may  be 
administered  simultaneously  with  the  former  remedy.  Or 
rather,  since  to  administer  it  simultaneously  might  involve 
the  risk  of  the  chemical  reaction  of  the  drugs,  the  remedies 
may  be  alternated.  It  will  not  interfere  with  the  former 
remedy,  because  attenuated  medicines  act  only  by  virtue  of 
their  homceopathicity  to  the  disease  (to  which  they  are 
respectively  homoeopathic).  Thus  each  drug  "  will  go  to  its 
own  place,"  like  the  respective  members  of  a  well- trained 
coach  team  when  the  winding  horn  announces  that  the  coach 
is  ready  for  the  new  relay  ! 

Such  is  the  argument  for  alternation  succinctly,  and,  we 
think  it  will  be  conceded,  fairly,  stated.  In  a  former  discus- 
sion of  this  subject  we  showed  that,  assuming  natural  disease 
and  drug  disease  to  be,  for  the  purposes  of  this  argument, 
substantially  the  same  thing,  it  was  proving  too  imich  to 
demonstrate  that  two  or  more  diseases  co-existing  in  the 
body  could  not  and  do  not  affect  each  other.  This  would 
render  a  cure  of  a  disease  impossible ;  for  in  the  act  of 
curing  we  propose  to  cure  a  natural  disease  by  creating  in 
the  body  a  drug  disease  which  shall  annihilate  the  natural 
disease,  and  shall,  in  that  very  act,  be  itself  annihilated. 
When  a  certain  form  of  rheumatism  exists  in  the  body,  we 
give  Bryonia,  and  our  intention  is  that  Bryonia  shall  so  act 
upon  the  body  (producing,  therefore,  virtually,  a  Bryonia 
disease)  as  to  cause  the  disappearance  of  the  rheumatism  and 
at  the  same  time  not  to  leave  in  its  stead  a  Bryonia  disease 
nor  any  other  disease.  But  if  two  diseases  co-existing  cannot 
react  upon  and  modify  each  other,  how  could  a  cure  take 
place  ?  The  proposition  is  evidently  too  broad ;  the  argu- 
ment proves  too  much. 

Dr.  Drysdale  provides  against  this  objection  by  limiting 
the  alleged  possible  independent  co-existence  of  diseases,  to 
diseases  which  act  in  a  dissimilar  manner  upon  remote  or 
unrelated  organs  and  tissues. 


ALTERNATION   OF   REMEDIES.      NO.    2.  2O5 

According  to  this  view,  two  diseases  might  co-exist  and 
not  modify  each  other,  if  seated  in  organs  distant  from  each 
other  or,  which  is  equivalent,  a  natural  disease  may  exist, 
and  a  drug  may  be  given  which  acts  only  upon  organs 
remote  from  those  which  are  the  seat  of  the  disease,  and  (if 
the  doses  be  strong  enough)  may  produce  its  peculiar  drug 
disease  without  at  all  affecting  the  natural  disease  which  is 
already  present. 

In  other  words,  it  is  only  diseases  (whether  natural  or 
drug  diseases)  which  are  homoeopathically  related  to  each 
other,  that  are  incompatible  and  may  not  co-exist  without 
modifying  each  other. 

Dr.  Drysdale  and  several  other  physicians  hold  these 
views,  and  appeal  to  their  own  observation  and  experience. 
If  we  may  be  allowed  to  draw  an  inference  from  Dr.  Drys- 
dale's  remarks,1  he  believes  that  a  hepatitis  may  supervene 
upon  an  already  active  pneumonia,  and  that  each  may  run  an 
independent  course,  and  be  treated  independently  by  alter- 
nated remedies,  without  modifying  each  other  or  blending 
into  one  morbid  state. 

Our  own  experience  has  led  us  to  very  different  conclu- 
sions, and  we  have  on  our  side  the  names  of  colleagues  who, 
not  having  deviated  from  the  modes  of  practice  observed  by 
Hahnemann's  early  disciples,  do  not  feel  compelled  to 
acknowledge  and  lament,  as  Dr.  Drysdale  does,  that  their 
practice  is  "not  proportionally  so  successful  as  was  that  of 
Hahnemann's  early  followers.2 

How  can  this  direct  contrariety  of  inferences  from  observa- 
tion be  explained  ?  We  have  altogether  too  profound  a 
respect  for  the  observing  and  reasoning  powers  of  our  dis- 
sentient friends,  to  set  them  a  particle  below  our  own  !  There 
must  be  an  opposition  in  some  of  our  methods  of  observa- 
tion, or  principles  of  inference.  It  will  be  found,  we  think, 
in  the  fact  that  to  the  word  "disease"  we  respectively  attach 

^Annals  of  British  Horn.   Sot.,  No.       *New  Repertory,  Introduction. 
17.  P-  375- 


206  ALTERNATION   OF  REMEDIES.      NO.    2. 

very  different  ideas.  We  mean  by  disease  the  aggregate  of 
those  symptoms  presented  by  the  sick  man,  which  are  char- 
acteristic of  his  particular  deviation  from  a  healthy  state. 
The  colleagues  from  whom  we  differ  speak  of  disease  as 
denoting  a  definite  pathological  and  pathologico-anatomical 
change  of  the  functions  and  tissues  of  some  definite  organ 
or  system  of  organs. 

In  this  latter  view  the  patient  might  present  evidence  of 
those  pathological  changes  in  the  organs  and  functions  of 
respiration,  to  which  the  name  pneumonia  has  been  attached. 
Here  then  is  one  disease,  pneumonia. 

He  may  also  present  evidences  of  those  pathological 
changes  of  function  and  tissue  in  the  liver  which  give  rise  to 
the  name  hepatitis.  And  here  would  be  another,  co-existent 
disease,  hepatitis ;  and  these  two  pathological  and  pathologi- 
co-anatomical conditions  might,  we  freely  admit,  from  the 
pathological  and  nosological  stand-point,  run  their  course  to 
resolution  or  to  destruction  without  so  modifying  each  other 
as  to  coalesce  or  in  any  way  blend  or  be  confounded  ;  for  the 
lungs  and  the  liver  can  never  collide. 

But,  let  it  be  borne  in  mind,  we  are  discussing  a  question 
of  practical  medicine  and  not  one  of  pathology  or  of  nosol- 
ogy- 
How  would  this  case  look  from  our  stand-point?  The 
patient  has,  we  suppose,  dyspnoea,  stitching  pain  in  the 
thorax,  hard,  dry  cough  from  tickling  behind  the  sternum, 
scanty  and  occasionally  bloody  sputa — headache  on  the 
vertex,  and  sharp  fever.  He  is  worse  at  night ;  his  pains  are 
much  aggravated  by  motion,  and  are  relieved  by  repose  and 
by  warmth. 

We  have  selected  Bryonia  for  him — had  previously  diag- 
nosticated pneumonia  (physical  signs  aiding  or  confirming 
our  diagnosis).  Now  he  gets,  in  the  hepatic  region,  stick- 
ing pains,  fullness  and  tenderness ;  he  has  bilious  vomiting 
and  bitter  taste.  Aided  again  by  physical  signs,  we  diag- 
nosticate hepatitis,  complicating  the  pneumonia;  but  the 


ALTERNATION   OF   REMEDIES.      NO.    2.  2O/ 

symptoms  still  indicate  Bryonia,  and  so  we  continue  that 
remedy. 

But,  we  shall  be  asked,  suppose  the  new  symptoms  do  not 
indicate  Bryonia,  but,  on  the  contrary,  some  other  drug,  will 
you  not  give  that  other  drug  for  the  liver  and  continue  the 
Bryonia  for  the  pneumonia  ? 

To  this  we  reply  that  in  so  far  as  our  observation  has 
taught  us,  in  such  a  case  the  supervening  of  these  new 
symptoms  (of  the  liver,  namely)  will  have  so  modified  the 
whole  organism,  including  the  diseased  respiratory  organs, 
that  Bryonia  will  no  longer  be  indicated  by  any  symptoms  ; 
but  the  aggregate  of  characteristic  symptoms  of  the  entire 
sickness  will  now  indicate  some  other  remedy  which  will 
apply  to  and  will  cover  the  whole  morbid  state  of  that 
individual. 

Here  we  are  again  at  issue.  Dr.  Drysdale  and  his  friends 
appeal  to  certain  observations  which  we  will  now  briefly 
discuss. 

In  the  discussion  which  followed  the  reading  of  Dr.  Drys- 
dale's  paper  in  the  British  Homoeopathic  Society,  Dr.  Rus- 
sell took  the  same  ground  as  Dr.  Drysdale.  He  said :  "  That 
two  morbid  specific  actions  could  occur  simultaneously  in 
the  human  body,  and  each  pursue  its  course  without  arrest- 
ing or  modifying  the  other,  is  a  proposition  entirely  at 
variance  with  the  opinions  of  the  old  pathologists  who 
flourished  before  the  time  of  Hahnemann.  *  *  It  is  of 
great  importance  to  us  to  know  whether  this  pathological 
doctrine  be  in  accordance  with  the  larger  experience  and 
observation  to  which  we  now  have  access." 

We  could  hardly  have  two  diseases  more  specifically 
distinct  than  typhus  and  small-pox,  yet,  in  the  following 
narrative,  we  have  a  description  of  the  two  running  their 
course,  side  by  side,  without  either  interfering  with  the 
other."  The  case  occurred  in  the  London  Fever  Hospital, 
and  is  quoted  by  Dr.  Murchison. 

Dr.  Russell  proceeded  to  say  :  "  There  are  many  instances 


208  ALTERNATION   OF   REMEDIES.       NO.    2. 

of  a  similar  kind  on  record,  and  we  must  frame  our  theories 
so  that  they  shall  embrace  this  new  category  of  cases. 
Suppose  we  encounter  a  case,  and  there  are  such  on  record, 
of  a  combination  of  scarlet  fever  and  of  typhus,  how  are  we 
to  deal  with  it  ?  Are  we  to  engage  only  one  of  the  two 
destroying  agents,  and  let  the  other  alone  until  the  first  be 
entirely  subdued  ?  If  we  believe  it  is  impossible  for  two 
medicinal  actions  to  proceed  part  passu  in  the  animal 
economy,  this  is  the  rational  course  to  pursue,  and  the  one 
recommended  by  Hahnemann ! "  (This  is  an  inexcusably 
lax  statement.  Hahnemann  nowhere  ever  recommended 
that  we  should  make  only  a  part  of  the  patient's  ailment 
the  basis  of  our  choice  of  a  remedy ;  he  always  strongly 
insisted  on  our  considering  the  "  totality  of  the  symptoms," 
and  this  would  include  both  scarlet  fever  and  typhus.) 

But,  if  two  entirely  different  natural  morbid  processes 
can  co-exist  in  the  human  body  without  the  one  affecting 
the  development  of  the  other,  what  reason  is  there  why  there 
may  not  be  two  artificial  simultaneous  series  of  morbid 
phenomena,  each  equally  independent  of  the  other  ?  If 
scarlet  fever,  or  if  small-pox,  can  each  run  its  course,  while 
at  the  same  time  typhus  is  doing  so  likewise,  why  may  not 
Belladonna  and  Arsenicum  each  run  their  course  when  given 
in  alternation."1 

In  reference  to  this  last  question,  we  may  ask,  would  Dr. 
Russell  expect  to  get  pure  symptoms  of  any  drug  if  it  were 
proved  simultaneously  with  another  drug ;  would  he  believe 
that  the  two  drug-diseases  would  run  an  independent,  simul- 
taneous course  in  a  prover  ?  Would  he  practically  believe 
it  by  consenting  to  rely  upon  a  materia  medica  pura  made 
up  in  this  way  ?  Or,  which  is  the  same  thing,  would  he 
trust  to  a  materia  medica  composed  of  the  results  of  an 
artificial  (drug)  disease  running  "  an  independent  course 
simultaneously"  with  "a  natural  disease?"  In  other 
words,  would  he  trust  provings  made  on  sick  persons  ? 

1  Annals  British  Homoeopathic  Society,  xvii.,p.  399  et  seq. 


ALTERNATION   OF   REMEDIES.      NO.    2.  209 

We  know  he  would  not;  for  he  is  one  of  those  who 
reject  or  suspect  the  provings  of  many  of  our  most  val- 
uable drugs,  because  symptoms  observed  on  the  sick  are 
included  in  the  list,  or  because  the  provers  were  not 
careful  enough  to  exclude  other  morbific  or  toxic  agents 
while  proving. 

But  this  inconsistency  aside,  let  us  take  notice  that  in 
these  remarks,  and  in  this  citation  of  a  case  of  the  co-exist- 
ence of  two  diseases,  Dr.  Russell  speaks  altogether  from  the 
stand-point  of  the  pathologist  and  nosologist,  and  not  at  all 
from  that  of  the  practical  physician — the  stand-point  of 
therapeutics.  He  thinks  he  has  proved  his  case  if  he  has 
established,  what  nobody  is  disposed  to  deny,  viz.,  that  two 
nosological  abstractions,  called  by  distinct  names  (to  wit, 
scarlet  fever  and  typhus),  may  co -exist. 

'  Does  he  forget  that  nothing  is  more  firmly  established  in 
homoeopathic  practice  than  that  the  "  name  "  which  we  may 
feel  authorized  to  give  to  a  sickness  in  no  wise  determines 
our  treatment  of  the  sickness  ?  Because  we  call  the  sickness 
typhus,  we  do  not  therefore,  of  necessity,  give  Arsenicum,  or 
scarlet  fever  Belladonna  !  We  may  as  often  have  to  give 
Arsenic  in  a  case  that  we  should  call  scarlet  fever,  and  Bella- 
donna in  a  typhus. 

What,  then,  guides  us  in  selecting  a  remedy?  Nothing 
save  the  aggregate  of  the  characteristic  symptoms.  We 
might  divide  and  subdivide  the  symptoms  and  signs  that  the 
sick  man  presents  (including  under  the  designation  "  symp- 
toms and  signs  "  everything  that  distinguishes  that  sick  man 
from  himself  when  not  sick)  into  a  dozen  nosological  groups, 
each  having  a  distinct  name,  and  yet  the  aggregate  of  these 
symptoms  might  (and  we  think  it  always  would)  point  to 
one  single  remedy  as  corresponding  to,  and  indicated  by,  the 
entire  morbid  state  of  that  sick  man. 

To  prove  his  case  by  the  argument  and  instances  quoted, 
Dr.  Russell   must    show  that  the   symptoms   of  the  scarlet 
fever  and  of  the  typhus,  respectively,  were  incompatible  in 
15 


210  ALTERNATION   OF   REMEDIES.      NO.    2. 

the   case   cited  by  him,  and  that  they  did  not  combine  to 
present  the  characteristics  of  one  common  remedy. 

For  this  is  the  point  of  the  whole  discussion.  No  matter 
how  many  of  the  pathological  groups  which  are  dignified  by 
the  names  of  distinct  diseases  may  co- exist  in  a  patient,  if 
they  be  so  blended  and  mutually  modified  as  to  indicate,  in 
the  aggregate,  one  single  remedy,  there  can  be  no  call  for 
alternation, 

Inasmuch  as  Dr.  Russell  rests  his  argument  for  alternation 
on  the  possible  and  frequent  co-existence  of  distinct,  specific 
forms  of  disease,  it  is  incumbent  on  him  to  show  that  these 
co- existent,  distinct  forms  of  disease  do  not,  by  their  co-ex- 
istence, modify  each  other  and  blend  into  one  harmonious 
aggregate  of  symptoms,  the  characteristic  ones  of  which 
may  be  covered  by  a  single  remedy.  In  our  experience 
this  has  always  seemed  to  be  the  case,  and  we  shall  adduce. 
other  evidence  to  the  same  effect. 

But  before  citing  authorities,  let  us  point  out  how  far  Dr. 
Russell's  argument,  even  allowing  it  full  force,  comes  short 
of  being  a  defense  of  alternation,  as  it  is  actually  practiced 
here  and  in  England  !  Dr.  Russell  allows  it  where  "  two 
distinct,  specific  forms  of  disease  "  co-exist,  such  as  scarlet 
fever  or  small-pox  and  typhus — a  phenomenon  that  no 
physician  in  ordinary  family  practice  is  likely  to  observe 
more  than  once  a  week !  Yet  how  many  times  a  day  do  a 
majority  of  our  colleagues  alternate?  It  is  safe  to  say  that, 
with  very  many,  the  giving  a  single  remedy  is  the  infrequent 
exception!  Their  case  is  exactly  met  by  the  following 
remarks  of  Dr.  Russell,  one  of  the  champions  of  alternation: 

"The  objection  usually  urged  against  alternation  is  that 
it  leads  to  laxity  of  practice.  True,  if  we  give  two  medi- 
cines instead  of  one  and  let  the  system  take  its  choice,  as 
it  were,  to  which  it  shall  submit — if,  in  a  given  case,  for 
example,  we  find  two  medicines  pretty  nearly  indicated,  and, 
instead  of  ourselves  selecting  the  one  and  rejecting  the  other, 
we  toss  them  both  in,  trusting  that  the  right  one  will  act, 


ALTERNATION    OF   REMEDIES.      NO.    2.  211 

and  the  other  be  a  nonentity  or  negative  quantity.  No 
ONE  WHO  DEALS  CONSCIENTIOUSLY  WITH  HIMSELF  WILL 
DELIBERATELY  APPROVE  OF  SO  SIMPLE  A  METHOD  OF 
EVADING  THE  DIFFICULTY  OF  CHOICE." 

A  few  instances  and  citations  may  serve  to  recall  to  the 
minds  of  practitioners  of  medicine,  the  frequent  instances 
in  which  two  varieties  of  disease,  co-existing,  modify  each 
other.  A  young  person  whose  parents  died  of  consumption, 
and  who  has  himself  had  abscesses  of  the  cervical  glands 
and  eruptions  of  the  face  and  who  takes  cold  readily — is 
feeble  and  pale — who,  in  short,  has  scrofulosis  and  is  a  pre- 
destined victim  of  consumption,  gets  an  attack  of  enteritis 
or  of  pneumonia.  Is  it  not  notorious  that  the  joint  action 
and  reaction  upon  each  other,  of  this  chronic  scrofulosis  and 
the  acute  enteritis  or  pneumonia,  will  be  such  that  instead 
of  the  acute  affections  running  the  short  and  sharp  course 
which  they  would  follow  in  a  robust  subject,  they  will  almost 
surely  degenerate  into  tuberculosis  of  the  mesenteric  glands 
with  colliquative  diarrhoea,  and  of  the  lungs,  respectively? 
And  would  any  one  dream  of  treating  these  acute  affections 
in  such  a  subject  just  as  they  would  treat  them  in  a  subject 
otherwise  and  previously  healthy? 

But  why  not  ?  Because  the  previously  existing  disease 
modified  and  (so  far  as  symptoms  are  concerned)  blended 
with  the  acute  attacks.  No  doubt  one  single  remedy  will 
cover  this  blended  case. 

When  a  patient  has  suffered  from  paroxysms  of  intermit- 
tent fever,  and  on  the  cessation  of  their  regular  recurrence 
he  is  still  sallow,  feeble,  dyspeptic  and  full  of  malaise,  there 
can  be  no  question  that  he  still  suffers  from  the  disease — the 
result  of  marsh  miasm.  If  now  this  patient  get  a  pneumonia 
or  a  neuralgia,  here  will  be  a  second  and  a  distinct  and 
dissimilar  disease  co-existing  with  the  former.  So  different, 
however,  will  be  its  course  from  what  it  would  have  been  in 
a  patient  not  laboring  under  miasmatic  disease, — so  blended 
will  it  be,  from  the  beginning,  with  the  latter, — that,  though 


212  ALTERNATION    OF   REMEDIES.      NO.    2. 

a  wholly  distinct  "  pathological  form "  of  disease,  it  will 
require  the  identical  treatment  of  miasmatic  disease  and  will 
yield  to  nothing  else.  The  same  thing  is  eminently  true  of 
syphilis  in  the  system. 

Bonchut  says : J  "  Syphilis,  herpetism,  scrofula,  the  marsh- 
miasmatic  disease,  etc.,  often  appear  under  forms  not 
habitual.  *  *  *  We  imagine  that  we  are  deal- 
ing with  acute  or  chronic  inflammations,  and  we  treat  them 
as  such  until,  some  day,  changing  our  method,  we  see  them 
recover,  one  under  Mercury,  another  under  Sulphur,  another 
under  Sulphate  of  quinine,  another  under  Iodine,  etc.  Is 
there  anything  stranger  than  those  observations  in  marshy 
countries,  where  pneumonia,  fever,  encephalo-meningitis, 
are  cured  by  Quinine  rather  than  by  blood-lettings  and  by 
antiphlogistics  ?  " 

Another  instance  of  the  modifying  power  of  two  morbid 
influences  co-operating  on  the  same  individual  is  furnished 
by  the  fact  that  when  an  epidemic  prevails  not  only  are 
almost  all  healthy  persons,  to  some  extent,  affected  by  the 
epidemic  influence,  but  the  maladies  of  all  sick  persons, 
whatever  their  nature  may  be,  are  modified  and-  changed 
into  a  greater  or  less  conformity  with  the  epidemic,  what- 
ever it  may  be. 

Dr.  David  Hosack  uses  these  words:2  "The  fact  stated 
by  Sydenham  and  other  writers  on  epidemics,  that  the 
prevailing  disease  swallows  up  all  other  disorders ;  that  is, 
that  during  the  prevalence  of  an  epidemic  plague,  typhus, 
dysentery  or  other  diseases  of  this  class,  every  indisposition 
of  a  febrile  sort  readily  assumes  the  character  of  the  prevail- 
ing disorder.  We  know  this  to  be  experienced  in  the 
diseases  of  other  countries,  and  we  see  it  daily  exemplified 
in  our  own." 

Homoeopathicians  especially,  since  their  observations  are 
finer  and  are  less  exposed  to  fallacy  from  drug-poisonings, 

1  Pathologie  Generale,  p.  269.  *  Copland's  Diet.    Pratt.  Med.,   2, 

404,  note. 


ALTERNATION   OF  REMEDIES.      NO.    2.  213 

have  opportunity  to  make  observations  of  this  kind,  and 
they  have  often  noticed  how,  at  one  season  and  under  one 
epidemic,  a  single  drug  or  group  of  drugs  corresponds  to 
the  most  diverse  pathological  forms  of  disease,  while  at  other 
seasons  and  under  other  epidemic  influences,  very  different 
groups  of  remedies  are  indicated  by  the  same  pathological 
forms  of  disease. 

And  we  believe  that  most  Homceopathicians  who  have 
dealt  much  with  chronic  cases,  must  have  fallen  in  with 
patients  who  labor  under  such  a  constitutional  affection  as 
herpes  or  cancer,  and  which,  under  favorable  circumstances, 
is  kept  in  a  latent  condition  by  the  occasional  use  of  some 
clearly  indicated  remedy.  If  these  patients  get  an  acute 
disease  of  whatever  kind,  this  disease  is  almost  sure  to 
present,  at  an  early  period,  symptoms  which  indicate  this 
same  remedy  that  suits  their  chronic  malady.  Does  not 
this  argument  a  posteriori  show  that  these  two  independent, 
co-existent  maladies  blend  and  modify  each  other,  at  least  in 
the  view  of  the  therapeutist  ? 

The  entire  homoeopathic  doctrine  of  chronic  diseases,  and 
the  use  and  necessity  of  so-called  antipsoric  remedies,  are 
based  upon  this  same  idea  of  the  mutually  modifying  influ- 
ence of  two  co-existent  maladies. 

Hahnemann  says  he  found  that  in  some  persons  acute 
disorders  did  not  yield  promptly  to  remedies  which  seemed 
indicated  and  which  quickly  cured  them  in  others.  On 
examining  closely  he  found  these  patients  presented,  in  the 
present  or  in  the  past,  symptoms  indicating  their  infection 
by  certain  miasms  which  he  reduced  (whether  rightly  or  not 
is  immaterial)  to  three  miasms — psora,  syphilis  and  sycosis. 
He  sought  for  remedies  which  would  meet  the  indications  of 
these  chronic  miasms  and  the  acute  affections  combined,  and 
this  led  him  to  prove  and  use  the  remedies  known  as  the 
antipsorics.  Our  success  with  those  remedies  might  be  taken 
as  another  a  posteriori  proof  of  the  blending  of  two  co-exist- 
ing diseases. 


214  ALTERNATION    OF   REMEDIES.      NO.    2. 

Dr.  Drysdale,  apologizing  for  the  practice  of  alternation, 
says: 

"We  have  not  a  few  examples  where  the  patient  has, 
through  ignorance  or  design,  unknown  to  us,  taken  large 
doses  of  heterogeneous  drugs,  such  as  Quinine  or  Opium  or 
purgatives,  and  yet  our  higher  dilutions  have  taken  effect 
notwithstanding.  On  this  subject  Trinks  confirms  Kampfer's 
remark,  that,  in  chronic  diseases  which  have  been  long 
treated  with  excessive  doses  of  allopathic  medicines,  we  often 
find  a  great  susceptibility  to  the  action  of  homoeopathic 
medicine." 

Are  these  writers  to  be  understood  as  maintaining  that 
chronic  drug-poisonings,  such  as  the  mercurial,  the  sulphur, 
the  iodine,  the  quinine,  the  iron  or  the  opium  cachexy,  do 
not  cause  acute  disease  to  be  most  difficult  of  cure  ?  The 
contrary  is  notoriously  the  case,  as  the  literature  of  phy- 
sicians of  every  school  abundantly  shows.  How  can  this  be, 
unless  the  artificial  chronic  disease,  viz.,  the  cachexy,  blend 
with,  and  modify,  the  supervening  acute,  natural  disease ! 

These  remarks  might  be  extended  to  great  length  by  mul- 
tiplied instances.  They  suffice,  however,  to  show  distinctly 
the  practical  conclusions  to  which,  what  we  conceive  to  be 
sound  principles,  as  well  as  accurate  observation,  have  led 
us.  With  them  we  conclude  what  we  have  to  say  concerning 
the  alternation  of  remedies,  taking  our  leave  of  the  subject 
in  the  spirit  of  Bishop  Chillingworth's  declaration  : 

"  I  will  take  no  man's  liberty  of  judgment  from  him  ;  nei- 
ther shall  any  man  take  mine  from  me.  I  will  think  no  man 
the  worse  man,  *  *  I  will  love  no  man  the  less  for  differ- 
ing in  opinion  from  me.  And  what  measure  I  mete  to  others 
I  expect  from  them  again." 


EDITORIAL  REMARKS  ON  ALTERNATION.1 

I. 

We  publish  with  great  pleasure  articles  which,  like  the 
above,  though  they  seem  to  favor  a  practice  which  we  depre- 
cate, are,  nevertheless,  honest  expressions  of  the  earnest 
convictions  of  men  of  close  observation  and  faithful  study. 

Nothing  could  be  farther  from  our  intention  than  to 
undertake  to  dogmatize  on  this  question,  which  we  admit  to 
be  an  open  question,  and  on  which  men  of  eminence  enter- 
tain opinions  at  variance  with  our  own.  It  may  be  allowed 
us,  nevertheless,  in  all  courtesy  to  our  contributor,  to 
signify  the  points  on  which  we  take  issue  with  him. 

i.  We  assuredly  do  entertain  the  belief  that  "two  or  more 
medicinal  forces  (or,  we  prefer  to  say  "morbific  forces") 
cannot  together  act  upon  the  economy  without  so  modifying 
each  other  that  neither  shall  produce  the  effect  it  would  if 
only  one  were  acting."  This  belief  has  prevailed  among 
medical  men  from  the  earliest  ages.  It  is  the  foundation  of 
the  practice  of  polypharmacy  in  all  its  varieties,  from  the 
complex  prescriptions  of  the  seventeenth  century  to  the 
alternations  of  our  own  colleagues.  For  we  hold,  with  Dr. 
Sorge  (by  no  means  a  Hahnemannian,  let  us  add),  that 
"  the  practice  of  alternation,  as  it  exists  among  homceopa- 
thicians,  is  only  another  form  of  mixing  remedies  with  the 
intention  of  getting  an  effect  compounded  of  the  action 
of  the  two  or  more  drugs  that  are  alternated." 

We  say,  this  belief  is  the  foundation  of  polypharmacy. 
The  rationale  of  a  compound  prescription  we  take  to  be  the 
following:  the  drug  which  is  regarded  as  the  one  chiefly 

1  Suggested  by  a  contribution  by  Dr.  H.  to  the  American  Homoeopathic 
Review,  vol.  v.,  February,  1865. 


2l6  EDITORIAL   REMARKS   ON   ALTERNATION. 

indicated  possesses,  let  us  suppose,  certain  properties  which 
would  be  hurtful  to  the  patient.  Another  drug  is  conjoined 
with  it  for  the  purpose  of  antidoting  those  hurtful  proper- 
ties. Again,  it  lacks  the  power  to  produce  certain  effects 
which  are  deemed  desirable.  Another  drug  is  added  to 
supplement  this  deficiency,  and  so  on;  ad  infinitum.  This 
entire  procedure  rests  on  the  belief  that  these  medicinal 
forces  will  so  modify  each  other  in  the  economy  that  neither 
shall  produce  the  effect  it  would  if  only  one  were  acting. 

As  an  example,  we  mention  calomel  and  opium,  a  very 
familiar  combination.  Certainly  the  object  of  giving  the 
opium  is  that  it  may  modify  the  action  of  the  calomel,  and 
in  a  way  which  conforms  to  the  known  action  of  opium  when 
given  alone. 

If  there  were  no  reason  to  believe  that  "  two  or  more 
morbific  forces  (a  drug  is  a  morbific  agent  exciting  a 
morbific  force)  could  not  together  act  upon  the  economy, 
without  so  modifying  each  other  that  neither  shall  produce 
the  effect  it  would  if  only  one  were  acting,"  how  could  we 
ever  cure  disease  ?  The  morbific  force  which  constitutes  the 
disease  is  acting  upon  the  economy,  and  we  bring  to  bear 
upon  the  economy  another  morbific  force,  viz.,  a  drug.  Now, 
if  the  latter  be  properly  selected  with  reference  to  the  former, 
we  know  that  these  forces  will  so  modify  each  other  that,  on 
the  one  hand,  the  manifestations  of  disease  will  cease,  and 
on  the  other  hand,  the  drug  will  not  produce  pathogenetic 
symptoms  as  it  would  on  the  healthy  subject.  This  state- 
ment rests  on  the  basis  of  such  "facts"  as  our  friend  invokes. 
On  what  other  theory  than  the  mutual  modification  of  mor- 
bific forces  acting  together  upon  the  economy  could  it  be 
explained  ? 

On  what  other  theory  could  we  explain  the  action  of 
antidotes  as  homceopathicians  understand  and  employ  them  ? 
How  else  could  we  explain  the  action  of  Belladonna,  in 
large  doses,  in  antidoting  poisonous  doses  of  morphine1  as 

1  American  Journal  Medical  Science,  January,  1862. 


EDITORIAL   REMARKS   ON   ALTERNATION.  217 

well  as  the  mutual  antidoting  powers  which  allopaths  have 
recently  discovered,  many  of  the  cerebro  stimulants  and 
spinant  alkaloids  to  possess  ?  How  else,  finally,  could  we 
explain  the  efficacy  claimed  for  the  practice  of  alternation 
in  general  and  for  certain  instances  of  it  in  particular,  such 
as  the  cases  related  by  Dr.  H.,  and  which  we  fully  credit, 
where  Belladonna  and  Bryonia  in  alternation  accomplished 
what  neither  could  do  singly,  and  where  Arsenic  and  China 
in  alternation  cured  a  case  which  neither  alone  had  cured  ? 
How  else  but  by  conceding  that  two  or  more  medicinal 
forces  cannot  act  together  upon  the  economy  without  so 
•  modifying  each  other,  that  neither  shall  produce  the  effect  it 
would  if  only  one  were  acting  ? 

The  fact  that  medicinal  or  morbific  influences  must  be 
avoided  when  we  are  engaged  in  proving  drugs  is  universally 
admitted ;  even  Dr.  H.  assented  to  it.  But  on  what  other 
grounds  than  the  belief  already  stated  ? 

That  persons  long  accustomed  to  use  tobacco  or  coffee  are 
not  easily  affected  by  drugs  is  accounted  for,  probably,  by  the 
fact  that  long  habit  has,  in  so  far  as  those  persons  are  con- 
cerned, caused  tobacco  or  coffee  to  cease  to  be  "  medicinal 
forces."  Use  has  become  "second  nature."  That  in  per- 
sons not  accustomed  to  the  use  of  coffee,  a  dose  of  it  will 
modify  the  action  of  another  morbific,  or  medicinal,  force  is 
demonstrated  by  the  effect  of  coffee  antidoting  opium,  Nux 
vomica,  alcohol,  as  well  as  in  neutralizing  the  beneficial 
curative  action  of  many  drugs,  as  our  clinical  observations 
often  satisfy  us  that  it  does.  The  same  statements  apply  to 
tobacco. 

2.  We  think  we  may  then  assume,  as  conceded,  the  fact 
that  "  two  or  more  medicinal  forces  cannot  at  the  same  time 
act  upon  the  human  system,  without  mutual  modification." 
It  is  now  asked,  whether  granting  this  modification,  we  may 
not  avail  ourselves  of  it  to  derive,  from  the  alternate  use  of 
drugs  which  modify  each  other,  good  effects  that  we  have 
attained  in  no  other  way  ?  There  can  be  no  doubt  of  the 


2l8  EDITORIAL   REMARKS   ON   ALTERNATION. 

possibility  of  this  being  done,  no  doubt  that  it  has  been 
done  with  advantage;  as,  indeed,  Dr.  H.  shows  by  two 
instances. 

But,  in  the  present  state  of  our  science,  it  would  be  impos- 
sible for  any  one  to  lay  down  rules  for  the  selection  of  reme- 
dies to  be  given  in  alternation,  with  the  view  of  gaining  any 
desired  modification  of  the  action  of  each.  Nor  can  we  con- 
ceive of  the  possibility  of  arriving  at  any  such  law.  The 
rule  of  the  ancient  polypharmacy,  viz.,  to  select  remedies 
according  to  the  effects  which  they  produce  singly,  and  to 
combine  them  with  reference  to  the  effect  desired,  does  not 
always  work  well  in  practice.  For  example,  calomel  and 
opium  produce  a  combined  effect,  which  is  clearly  a  modifi- 
cation of  the  known  action  of  each  drug.  But  on  the  other 
hand,  the  combined  action  of  opium,  ipecacuanha  and  the 
sulphate  of  potash  in  Dover's  powder  is  quite  distinct  and 
different  from  that  of  either  constituent  alone,  and  is  such 
as  could  hardly  be  anticipated  from  what  we  know  of  these 
constituents. 

Arsenic  and  China  produced  a  combined  effect  which 
cured  an  ague  that  neither  singly  would  cure.  Now,  if  this 
fact  were  to  be  taken  as  a  guide  in  selecting  a  combination 
for  a  case  of  uterine  disease,  for  example,  in  which  we  were 
at  a  loss  to  decide  between  Sepia  and  Pulsatilla,  it  might 
lead  us  to  alternate  those  two  remedies.  But  it  is  not  three 
months  since  one  of  us  took  charge  of  a  case  in  which  this 
alternation,  on  this  very  ground,  had  been  employed,  but  the 
patient  had  not  recovered.  We  were  led  to  the  conclusion 
that  the  Sepia  was  really  the  remedy  indicated — that  it  did 
good,  but  that  its  effects  were  constantly  antidoted  by  the 
Pulsatilla.  We  omitted  the  Pulsatilla,  gave  Sepia  judiciously, 
and  the  patient  promptly  recovered. 

When,  in  addition  to  this  difficulty  arising  from  the  fact 
that  alternated  drugs  do  not  always  produce  a  morbific  action 
which  can  be  predicated  in  advance  from  their  known  single 
action,  we  consider  that  the  various  degrees  of  suscepti- 


EDITORIAL   REMARKS   ON   ALTERNATION.  2 19 

bility  of  the  organism  to  drugs  indicated  with  different 
degrees  of  accuracy,  will  cause  the  modification  by  drugs  of 
each  other's  action  to  be  different  in  each  individual  case,  we 
clearly  see  that  we  can  never  be  in  a  position  to  predicate, 
in  advance,  the  effect  of  the  joint  administration  of  several 
drugs.  We  can  never,  therefore,  have  a  scientific  indication 
for  such  a  combination  or  alternation.  If  we  make  it,  it 
must  always  be  the  result  of  "guess-work" — of  "feeling  our 
way  along,"  just  as  Dr.  H.  did  in  the  cases  he  relates. 

But  we  claim  superiority  for  Homoeopathy  in  that  it  gives 
us  the  means  of  selecting  our  remedies  with  a  reasonable 
certainty  of  their  effects,  and  we  rightly  claim  that  medicine 
should  not  rest  content  with  anything  short  of  a  method 
which,  given  the  symptoms  of  a  disease,  points  us  to  a  cer- 
tain remedy  if  our  materia  medica  contain  it ;  or,  given  the 
pathogenesis  of  a  drug,  indicates  to  us,  a  priori,  the  complex 
of  symptoms  which  the  drug  will  remove. 

But  the  method  of  alternation  throws  us  back  from  all 
such  certainty — back  to  the  field  of  unmethodized  clinical 
experience — back  to  the  trackless  wilderness  of  polyphar- 
macy  and  allopathy. 

For  these  reasons,  briefly  and  imperfectly  stated,  from  the 
stand-point  of  science  we  hold  that  homoeopathic  medicine 
cannot  countenance  nor  tolerate  alternation.  And  we  have 
such  a  faith  in  the  unity  of  nature  as  to  believe  that  what 
sound  reasoning  shows  to  be  erroneous,  accumulated  facts 
will  prove  to  be  mischievous  and  unnecessary. 

3.  But  there  is  another  view  of  this  matter  from  the 
practical  stand-point.  Dr.  H.  says  :  "  Grant  that  in  a  given 
case  of  the  use  of  two  remedies,  some  one  remedy  might 
have  been  found  that  would  as  well,  or  better,  have  answered 
the  purpose  *  *  *  the  question  is  not,  Could  some 
other  person  have  done  better  than  I,  but  Have  /  done  the 
best  I  could  ?  Undoubtedly,  yes  !  And,  so  far  as  the 
prescriber's  own  conscience  is  concerned,  this  answer 
exonerates  him,  even  though  his  prescription  were  a  faulty 


22O  EDITORIAL   REMARKS   ON  ALTERNATION. 

one.  And  in  so  far,  from  the  practical  point  of  view,  alter- 
nation may  be  justifiable.  But  will  this  question,  '  Have  I 
done  the  best  I  could  ? '  if  affirmatively  answered,  always 
justify  the  prescriber?  The  practitioner  of  one  year's 
experience  may  commit  a  sad  blunder  and  yet  be  fully 
justified,  because  being  inexperienced  and  young,  bad 
though  his  error  was,  he  did  'the  best  he  could.'  Would 
this  plea  justify  the  same  blunder  ten  years  later  ? 
Obviously  it  would  not.  Yet  is  it  not  the  tendency  of  this 
plea  to  satisfy  a  man  with  the  knowledge  he  has  and  with 
the  methods  he  pursues,  and  thus  to  blunt  his  zeal  for 
greater  knowledge  and  better  methods  ?  Remonstrate  with 
the  allopathist  for  murdering  patients  with  lancet  and  purge; 
he  replies,  '  I  act  according  to  my  light ;  I  do  the  best  I 
can.'  And  so  through  all  degrees  of  error  and  imperfect 
knowledge.  It  is  a  dangerous  plea,  unless  its  complement 
be  always  added,  '  I  have  done  the  best  I  can,  but,  please 
God,  I  will  do  better  next  time  !  "' 

And  here  we  see  the  advantage  of  a  sound  "theory" 
which  our  friend  holds  in  so  light  esteem. 

Suppose  a  practitioner  driven,  as  Dr.  H.  was  driven,  to 
alternate.  The  patient  recovers.  He  has,  nevertheless, 
a  conviction  that  drugs  modify  each  other's  action  in  a  way 
that  we  cannot  foretell,  and  that  the  action  of  the  entire 
organism  is  so  harmonious  that  "  two  morbid  states  cannot 
co-exist  independently,"  and  that,  therefore,  the  morbid 
state  being  essentially  one,  there  must  be  a  possibility  of  one 
similar  drug-disease  to  oppose  it.  A  sound  theory  compels 
him  to  the  belief  that  alternation  is  not  justifiable  nor 
defensible  on  scientific  grounds,  and  that  it  can  do  nothing 
to  advance  our  knowledge  of  Therapeutics,  but  rather  con- 
fuses it.  He  enters  in  his  mind  a  protest  against  the  practice 
to  which  the  necessities  of  practical  duty  and  his  limited 
knowledge  of  the  materia  medica  have  constrained  him,  and 
turns  with  redoubled  vigor  to  the  study  of  materia  medica, 
smarting  a  little  with  shame  that  the  exigencies  of  practice 


EDITORIAL  REMARKS   ON  ALTERNATION.  221 

have  found  him  unprepared,  and  have  compelled  him  to  a 
resort  which,  though  successful,  his  reason  condemns,  and 
determined  that  the  next  time  he  will,  if  possible,  be  equally 
if  not  more  successful,  and  by  a  method  which  shall  commend 
itself  to  his  reason,  and  shall  add  to  his  stock  of  knowledge 
for  future  use. 

And  if,  while  "doing  the  best  they  can,"  as  each  case 
presents  itself,  practitioners  will  earnestly  and  systematically 
study  the  materia  medica,  determined  to  do  better  and 
better  the  next  time,  we  shall  have  no  word  of  reproach  to 
utter  against  their  temporary  expedient  of  alternating  drugs. 
With  broader  knowledge  they  will  alternate  less  and  less, 
and  we  are  very  sure  that  they  will  see,  as  we  have  done, 
how,  in  case  after  case  in  which  they  had  alternated,  the 
recovery  was  in  truth  retarded  by  the  mutual  reaction  of 
the  drugs ;  and  how  the  careful  individualization  of  the  case, 
and  the  painstaking  selection  of  the  single  drug  in  the 
manner  that  Hahnemann  advised,  will  be  in  their  hands  the 
means  to  a  success  far  beyond  any  ever  reached  through 
alternation.  For,  though  we  have  admitted  and  do  admit 
that  success  is  often  attained  through  alternation,  and  that 
"  success  is  the  object  of  all  our  labors,"  we  are  nevertheless 
convinced,  through  our  own  experience, — for  we  have  alter- 
nated in  our  day, — that  a  much  larger  measure  of  success  is 
obtained  by  adherence  to  the  rule  of  administering  single 
remedies,  and  that  closer  study  of  the  materia  medica  and 
sharper  investigation  of  cases  will  preserve  us  from  those 
dilemmas  in  which  we  are  tempted  or  compelled  to  resort 
to  alternation. 

4.  And  if  we  appeal  to  the  experience  of  Hahnemann, 
let  it  be  understood  that  we  appeal  to  the  man  who  both 
knew  materia  medica  better  than  any  other  man  ever 
knew  it,  and  who  had  more  practical  experience  than  any  of 
us  has  had.  Let  us  not  indulge  in  the  fallacy  of  supposing 
that,  because  we  are  now  practicing  in  the  fifty-ninth  year 
since  the  Organon  was  published,  we  have  had  fifty- nine 


222  EDITORIAL   REMARKS   ON   ALTERNATION. 

years'  experience  in  homoeopathic  practice,  and  have  been 
studying  materia  medica  fifty-nine  years.  On  the  contrary, 
our  own  experience  is  measured  only  by  the  actual  number 
of  years  we  have  practiced  ;  since  in  this  matter  of  assimila- 
ting to  one's  own  mind  the  facts  of  the  materia  medica,  and 
of  seeing  the  correspondence  between  these  and  the  facts  of 
the  disease,  we  can  borrow  but  little  from  the  experience  of 
others. 

If  then  we,  from  our  little  experience  of  fifteen,  or  ten, 
or  five  years,  appeal  to  Hahnemann  with  his  venerable 
experience  of  more  than  fifty  years  of  active  practice,  with 
his  unapproachable  knowledge  of  the  materia  medica,  of 
which  he  might  justly  say  like  JEneas,  "  magnet,  pars  fui" 
with  his  unrivaled  powers  of  observation  and  discrimination ; 
if  we  appeal  to  him  as  "authority"  on  this  question,  at  once 
practical  and  scientific,  can  it  justly  be  said,  that  we  are 
seeking  some  "authority  outside  of  and  beyond  our  own 
reason?"  Our  colleague  appeals  to  collections  of  "facts." 
Is  not  Hahnemann's  statement  of  his  practical  conclusions  a 
most  stupendous  "collection  of  facts?"  Who  ever  observed 
so  many  of  them  ?  Who  ever  observed  so  well  as  he  ? 
Facts  must  be  received  on  testimony ;  who  ever  reported 
more  graphically  and  more  faithfully  than  Hahnemann  ?  If 
we  doubt  his  ability,  his  capacity,  his  candor,  what  are  we 
doing  with  his  materia  medica,  on  the  truth  of  which  we 
risk  our  patients'  lives  ? 

This  outcry  against  "swearing  in  the  words  of  the  master" 
has  come  to  have  a  very  different  meaning  from  that  of  the 
ancient  original  protest  It  was  never  meant  to  intimate 
that  the  opinion  and  testimony  of  him  whose  abilities  had 
crowned  him  "  king  of  men"  should  not  have  a  royal  weight 
of  influence. 


EDITORIAL  REMARKS  ON  ALTERNATION.1 

II. 

This  article  very  justly  affirms  that  the  question  of  alter- 
nation, being  a  practical  one,  "  must  be  decided  by  experi- 
ence ;  "  that  no  dogmatism  will  satisfy  those  differing  in 
opinion.  The  writer  then  straightway  proceeds  to  dogma- 
tize on  the  basis  of  two  assumptions,  which  he  claims  to  be 
"  established  principles  in  Homoeopathy,"  but  which  very  few 
will  concede  in  the  terms  in  which  he  has  expressed  them. 

Having  referred  the  question  to  experience,  he  makes  no 
appeal  to  experience,  whether  his  own  or  his  neighbor's-  If 
he  have  experience  which  can  throw  light  on  this  question, 
it  ought  to  be  comparative  experience.  He  ought  to  be 
able  to  say:  "  For  a  certain  period  of  times  I  avoided  alterna- 
tion, selecting  my  remedies  as  Hahnemann  directs  ;  then,  for 
a  period  I  alternated.  My  success  under  the  latter  method 
was  the  greater."  Such  a  statement  as  this  would  carry 
weight.  But  we  gather  from  this  article  that  the  author  has 
always  practiced  alternation,  deriving  his  ideas  of  its  pro- 
priety and  necessity  from  the  assumed  "established  prin- 
ciples "  upon  which  he  bases  his  arguments,  and  upon  the 
assumed  imperfections  of  the  materia  medica. 

If  our  conjecture  be  correct,  then  his  experience,  being 
confined  to  the  practice  of  alternation  and  not  bearing  upon 
the  opposite  method,  can  have  only  a  negative  value.  It 
merely  shows  that  a  measure  of  success  does  attend  this 
faulty  form  of  practice,  a  point  which  was  freely  conceded  to 
Dr.  H.2  But  inasmuch  as  no  advocate  of  alternation  claims 
invariable  success,  the  question  remains,  "  Might  not  the 

1  Suggested  by  a  contribution  by  Dr.  C.  to  the  American  Homeopathic 
Review,  vol.  v.,  April,  1865.  *  See  previous  paper. 


224  EDITORIAL   REMARKS   ON  ALTERNATION. 

success  have  been  greater  if  alternation  had  been  avoided?  " 
Not  having  any  comparative  experience  by  the  light  of 
which  to  answer  this  question,  the  alternator  ab  initio,  could 
not  reply. 

Our  editorial  note  to  Dr.  H.'s  paper  expressly  referred  to 
Hahnemann's  experience,  and  to  the  experience  of  the 
writer,  as  being  of  this  comparative  character,  and  as,  there- 
fore, bearing  on  this  question,  and  as  showing,  so  far  as  they 
go,  that  the  results  of  adherence  to  the  single  remedy  are 
more  satisfactory  than  those  of  alternation. 

Some  of  the  points  touched  by  Dr.  C.  are  too  important 
to  be  treated  in  this  annotation.  They  will  be  discussed  in 
a  future  number  of  the  Review?- 

Suffice  it  now  to  say  that,  when  he  states  that  "  the  only 
reason  why  he  practices  alternation  is  the  want  of  perfection 
of  the  materia  medica,"  he  concedes  (if  he  will  allow  us  to 
add  one  other  analogous  reason,  viz.,  "want  of  perfection  in 
the  knowledge  possessed  by  practitioners  of  the  materia 
medica  which  we  already  have")  all  that  the  opponents 
of  alternation  contend  for.  For  this  position  admits  that 
alternation  is  wrong  in  principle,  and  is  only  necessitated  by 
a  temporary  emergency.  We  contend  that  the  emergency, 
instead  of  being  common,  is  rare,  if  not  altogether  imaginary, 
and  we  appeal  to  our  practice. 

How  dangerous  it  is  to  discuss  a  question  of  science  with 
rhetorical  figures ! 

Dr.  C.  makes  merry  over  his  imagined  double-headed 
monster,  for  each  head  of  which  he  provides  a  club,  and  he 
grows  happy  at  the  thought  that  by  his  two-handed  energy- 
he  will  have  destroyed  this  figurative  disease  much  more 
quickly  than  the  luckless  editor  could  do  it,  whom  he 
restricts  to  the  use  of  a  single  club  to  be  applied  to  but  one 
head  at  a  time. 

Now,  we  have  always  supposed  that  the  efficacy  of  an 
armament  depended  not  so  much  upon  the  number  of 
1  See  "Alternation  of  Remedies,"  Nos.  i  and  2. 


EDITORIAL   REMARKS   ON   ALTERNATION.  225 

efficient  weapons  as  upon  the  skill  with  which  the  weapons 
existing  were  used,  and  one  club  in  a  vigorous  right  hand 
might  do  more  execution  even  on  a  double-headed  monster 
than  two  clubs  even  in  the  hands  of  our  ambidextrous  cor- 
respondent. But  why  restrict  the  monster  to  the  "  two- 
headed  "  form  ?  If  we  are  to  admit  the  dual  or  multiple 
independent  co-existence  of  disease,  why  not  liken  it  to  a 
centipede,  each  foot  "possessing  independent  vitality?" 
With  what  armament  now  will  our  friend  cope  with  his 
antagonist  ?  Shall  he  call  Briareus  in  consultation,  and  arm 
him  with  one  hundred  clubs  ?  We  do  not  believe  in  the 
multiple  co-existence  of  disease.  Leaving  out  of  view 
traumatic  affections  which  may  supervene  during  idiopathic 
sickness,  as  Drysdale  shows,  we  believe  in  the  unity  of 
disease,  and  we  expect  to  find  one  remedy  of  which  the 
characteristic  symptoms  cover  the  whole  case. 

The  figure  of  the  two-headed  monster  is,  therefore,  in  our 
view,  defective,  but,  admitting  the  figure,  why  must  we  use 
clubs  at  all  ?  In  the  days  when  brute  force  reigned 
supreme  they  were  well  enough.  But  surely  in  this  day  of 
enlightenment  "  clubs  are  not  trumps." 

Hercules  was  the  embodiment  of  brute  strength  as  dis- 
tinguished from  intellectual  acuteness  and  skill.  Surely  his 
subjugation  of  the  Lernean  Hydra  should  not  serve  us  as  an 
example  in  treating  disease.  We  cannot  afford  to  spend  so 
much  time  as  the  club  treatment  requires ;  for  both  the 
experience  of  Hercules,  and  that  of  our  Irish  friends  at  Don- 
nybrook  Fair,  prove  that  the  breaking  of  heads  by  clubs  is 
a  tedious  and  uncertain  affair.  We  decline  to  enter  into 
competition  with  our  friend  in  the  use  of  his  favorite  thera- 
peutic agent,  the  club,  whether  he  use  it  single,  double,  or  a 
hundred  fold.  But,  if  he  insist  on  a  mechanical  figure,  we 
will  suggest  that,  while  he  is  counting  the  heads  of  the 
monster  and  is  casting  about  in  his  club-room  for  a  bludgeon 
adapted  to  each  head,  and  is  fitting  his  hand,  for  the  arduous 
effort,  and  is  so  getting  his  balance  as  to  make  sure  that  the 
16 


226  EDITORIAL  REMARKS   ON  ALTERNATION. 

complex  wielding  of  his  numerous  weapons  shall  not  trip 
him  up,  we  shall  humbly  survey  the  monstrous  form  with 
the  intent  to  study  the  controlling  characteristics  of  his 
anatomical  structure,  and  when  we  shall  have  learned  to 
what  type  he  belongs  and  what  are  his  characteristics  as  an 
individual,  then  with  one  single  weapon  (a  slender  sword, 
it  may  be,  or  a  bodkin,  or  a  drop  of  prussic  acid),  we  shall 
touch  the  vital  part  (the  heart,  or  the  medulla,  or  a  delicate 
mucous  membrane)  on  whose  integrity  depends  the  life  of 
all  the  heads  and  all  the  rest — and  presto — before  the 
ponderous  clubs  have  time  to  fall  on  those  devoted  heads 
"belaboring  them  simultaneously" — the  work  is  done  ! 

Multiplicity  in  armament  is  generally  inconsistent  with 
simplicity  and  efficiency,  and  is  characteristic  of  a  barbaric 
age  or  race. 

Thus  the  double-club  array  is  known  as  the  "  Indian 
Clubs." 

The  Japanese  wear  two  swords,  and  yet  cannot  stand  a 
moment  before  the  single  rapier  of  the  Frenchman. 

The  savage  of  the  Southern  States  glories  in  his  belt  full 
of  six-shooters)  and  his  boot-legs  bristling  with  bowie-knives. 
Before :  the  single  purpose  of  the  Northern  Farmer  he  is 
rapidly  passing  into  the  realm  of  history. 


THE   USE   OF   HIGH   POTENCIES   IN  THE 
TREATMENT   OF  THE   SICK. 


Having  been  honored  by  the  President  of  the  Society1 
with  an  appointment  to  report  on  the  use  of  High  Potencies 
in  Chronic  Diseases,  I  trust  it  may  not  be  considered  an 
unwarrantable  presumption  if,  for  the  following  reasons, 
I  venture  to  modify,  to  a  slight  extent,  the  theme  assigned 
to  me. 

First.  The  subject  contemplates  a  report  of  a  practical 
nature.  But  from  the  stand-point  of  practice,  I  think  that  a 
clear  and  well-defined  distinction  between  acute  and  chronic 
diseases  is  not  possible.  If  we  attempt  to  base  such  a 
distinction  upon  the  element  of  time  alone,  paying  regard 
only  to  the  duration  of  the  disease,  it  cannot  be  made  at  the 
beginning  of  the  treatment,  and  cannot  therefore  be  of  any 
practical  value  in  determining  the  potency  to  be  used. 

If  we  base  the  distinction  upon  a  pathological  conception 
— that  is,  upon  the  presumed  existence  in  the  patient  of  some 
dyscrasia,  diathesis  or  miasm — it  is  equally  impossible,  at 
least  in  very  many  instances,  to  make  it  at  the  commence- 
ment of  an  illness. 

It  is  a  matter  of  common  remark  that  cases  which  begin 
without  any  sign  of  miasmatic  or  dyscratic  complication 
often  develop  in  their  course  unequivocal  evidence  of  such 
complication,  so  that  a  case  which  would,  in  the  outset,  have 
been  regarded  as,  in  this  sense,  unquestionably  acute,  proves 
in  its  course  to  be  unmistakably  chronic. 

Second.  Furthermore,  the  subject  as  stated,  involves  a 
kind  of  petitio  principii.  To  require  a  report  on  the  "  Use 
1  The  Homoeopathic  Medical  Society  of  the  State  of  New- York,,  Oct.,  1863. 


228  THE   USE   OF  HIGH   POTENCIES 

of  the  High  Potencies  in  Chronic  Diseases"  is  in  some 
sort  to  imply  that  these  potencies  are  especially  useful  and 
appropriate,  if  at  all,  in  the  treatment  of  chronic  diseases 
as  distinguished  from  acute  diseases — an  implication  which 
it  is  true  corresponds  to  a  very  widely  received  opinion 
among  those  physicians  who  have  but  little  practical 
acquaintance  with  the  action  of  the  high  potencies,  but 
which,  as  we  shall  see,  is  not  supported  by  the  results  of 
experiment 

By  the  kind  indulgence  of  the  Society,  then,  I  shall  beg 
leave  to  report  on  the  "  Use  of  High  Potencies  in  the  Treat- 
ment of  the  Sick." 

No  question  connected  with  Homoeopathy  has  given  rise 
to  more  vigorous  controversy  or  to  more  earnest  partisan 
feeling  than  that  concerning  the  infinitesimal  dose.  The 
most  bitter  opposition  of  the  Old  School  to  Hahnemann  was 
based  on  this  question.  It  has  been  also  the  chief  ground 
of  division  and  contention  among  homceopathists  them- 
selves. 

After  an  animated  disputation  covering  a  period  of  more 
than  fifty  years,  there  seems  now,  however,  to  be  a  cessation 
of  hostilities  between  the  advocates  and  opponents  of  the 
higher  potencies.  There  seems  to  be  a  mutual  disposition 
to  suspend  the  discussion  hitherto  maintained  chiefly  on 
hypothetical  grounds,  and  to  appeal  in  good  faith  to  the 
" ultima  ratio"  —  experiment.  The  times  are  favorable, 
therefore,  for  a  quiet  survey  of  the  field  and  for  a  dis- 
passionate estimate  of  the  experimental  knowledge  of  which 
the  practical  labors  of  our  colleagues  have  put  us  in  pos- 
session. 

It  is  probable  that  Hahnemann  was  never  what  could  be 
called  an  "heroic  prescriber."  In  his  work  on  The  Venereal 
Disease,  published  1789,  before  he  had  discovered  the  hom- 
oeopathic law  of  cure,  he  portrays  the  evil  effects  of  exces- 
sive doses  of  mercurial  preparations,  and  speaks  of  radically 
curing  some  cases  of  syphilis  by  the  use  of  a  single  grain  of 


IN  THE  TREATMENT  OF  THE   SICK.  229 

Mercurius  solubilis  in  divided  doses;  and  says  that  eight 
grains  thus  administered  will  often  be  sufficient  to  cure  "very 
severe  cases  of  syphilis."  Compared  with  the  practice  of  his 
contemporaries,  these  are  almost  infinitesimal  prescriptions. 

In  his  first  essays  upon  the  homoeopathic  law,  Hahnemann 
advises  the  administration  of  doses  but  little,  if  any,  smaller 
than  those  he  had  previously  used.  We  first  meet  with  the 
recommendation  to  use  infinitesimal  doses  in  the  essays  on 
"Scarlet  Fever,"  published  in  1801,  but  referring  to  cases 
treated  in  1799.  He  here  advises  Belladonna  and  Chamo- 
milla  to  be  given  in  preparations  which  correspond  pretty 
nearly  to  the  third  centesimal  dilution. 

It  pleases  Dr.  Dudgeon  to  suppose  that  "this  sudden 
change,"  as  he  calls  it,  from  material  to  infinitesimal  doses, 
was  a  matter  of  expediency  and  policy  rather  than  of  con- 
viction on  the  part  of  Hahnemann,  inasmuch  as  it  coincided 
in  point  of  time  with  the  prosecutions  of  Hahnemann  by  the 
apothecaries. 

But  there  is  no  evidence  that  the  change  was  so  very 
sudden  as  to  require  such  an  explanation.  Even  so  short  a 
period  as  one  year  spent  in  constant  practice  might  be  suffi- 
cient to  satisfy  so  acute  an  observer  as  Hahnemann,  that 
remedies  given  according  to  the  homoeopathic  law  must  be 
given  in  very  small  doses. 

The  whole  career  of  Hahnemann  is  a  consistent  protest 
against  the  adoption  or  renunciation  of  any  procedure  con- 
nected with  the  practice  of  medicine,  on  grounds  of  mere 
policy  or  expediency.  Hahnemann's  long  life  was  a  con- 
tinual sacrifice  of  ease  and  prosperity  and  highly  prized 
friendships  to  his  convictions  of  truth.  While  therefore, 
during  a  period  of  twenty  years  he  submitted  to  be  driven 
from  city  to  city  rather  than  renounce  the  right  of  dispensing 
his  own  medicines,  is  it  at  all  probable  that  he  devised  the 
method  of  diluting  or  potentizing  remedies  and  insisted  on 
the  superiority  of  potentized  remedies,  simply,  or  in  any 
degree  from  motives  of  expediency  ? 


230  THE  USE   OF   HIGH   POTENCIES 

In  subsequent  essays  Hahnemann  advises  still  more  dis- 
tinctly the  administration  of  potentized  remedies,  and  in  the 
first  edition  of  the  Organon,  published  in  1810,  he  says: 
"Scarcely  any  dose  of  the  homceopathically  selected  remedy 
can  be  so  small  as  not  to  be  stronger  than  the  natural  disease 
and  not  capable  of  overcoming  it."  About  the  same  period 
he  advises  the  use  of  the  ninth  dilution  of  Nux  vomica  and 
the  eighteenth  of  Arsenic. 

In  the  earlier  volumes  and  editions  of  the  Materia  Medica 
Pura,  Hahnemann  recommends  a  particular  dose  for  each 
remedy.  Some  remedies  are  to  be  given  in  the  first  dilution, 
some  in  the  third,  some  in  the  ninth,  some  in  the  fifteenth, 
some  in  the  twenty-fourth,  some  in  the  thirtieth. 

In  subsequent  editions  of  the  Materia  Medica  and  in  the 
work  on  Chronic  Diseases,  Hahnemann,  as  is  well  known, 
advises  that  all  remedies  be  given  in  a  uniform  dose — the 
thirtieth  dilution. 

In  the  latter  years  of  his  life  he  speaks  of  using  with  great 
success  the  sixtieth,  one  hundred  and  fiftieth  and  three  hun- 
dredth dilutions,  and  it  is  well  known  that  during  these  years 
he  did  not  confine  himself  to  a  uniform  dose,  but  used  in  some 
cases  the  lower  potencies,  and  in  some  the  very  highest 

It  is  not  unworthy  of  remark  that  as  Hahnemann's  prac- 
tical experience  in  the  treatment  of  disease  increased,  so  did 
his  estimate  of  the  advantage  and  necessity  of  using  higher 
dilutions,  in  at  least  many  cases,  likewise  increase. 

The  promulgation  of  the  dynamization  theory  by  Hahne- 
mann, and  his  adoption  of  the  practice  of  giving  infinitesimal 
doses,  were  the  occasion  of  the  most  violent  denunciation  of 
Homoeopathy  by  his  professional  opponents.  Indeed,  to 
this  day,  this  really  subordinate  department  of  the  method 
is  regarded  by  allopaths  as  the  essential  feature  of  Homoe- 
opathy ;  and  to  a  superficial  observer  it  would  seem  as  if  the 
infinitesimal  dose  were  almost  the  only  obstacle  to  a  blend- 
ing of  Homoeopathy  and  the  so-called  Physiological  School 
of  Medicine. 


IN  THE  TREATMENT  OF  THE  SICK.  231 

The  progressive  advocacy  by  Hahnemann  of  the  higher 
dilutions,  and  especially  the  introduction  by  Korsakoff  of 
what  are  technically  known  as  the  "  high  potencies  "  (the 
one  hundred  to  fifteen  hundredth)  gave  rise,  as  has  been 
said,  to  a  lively  and  bitter  and  decidedly  personal  contro- 
versy among  homceopathists. 

In  every  party  or  school  which  is  still  a  minority,  there 
are  always  Conservatives,  who  regret  the  necessity  which 
compelled  a  separation  from  the  party  or  school  of  the 
majority;  who  strive  to  make  that  separation  as  little 
decisive  and  marked  as  may  be ;  who  stoutly  oppose  any 
measure  which  would  tend  to  increase  the  division  or  to 
make  it  irremediable ;  and  who  hail  with  delight  almost  any 
project  of  compromise  or  reunion.  There  are  also  Radicals, 
whose  turbulent  nature  revels  in  the  sensation  of  opposition; 
whose  tendency  it  is  to  lay  more  stress  on  points  of  differ- 
ence than  on  points  of  coincidence ;  who,  having  once 
separated  from  the  majority,  will  not  only  entertain  no 
thought  of  a  reunion  with  them,  but  consider  that  fidelity  to 
the  principle  on  which  their  separation  was  based,  requires 
that  the  separating  chasm  should  be  made  continually  wider. 
They  seem  to  glory,  not  so  much  in  the  truth  for  the  sake 
of  which  they  separated,  as  in  the  mere  fact  of  separation. 

These  two  classes  are  necessary  in  every  progressive 
school.  The  Radicals  furnish  the  propelling  force — the 
steam.  The  Conservatives  supply  the  restraining  and 
moderating  influence — the  fly-wheel. 

Among  the  followers  of  Hahnemann,  the  Radicals  and 
the  Conservatives  were  the  respective  parties  to  the  contest 
about  the  potentization  theory ;  and  in  weighing  the  argu- 
ments which  each  side  brought  forward,  we  must  not  lose 
sight  of  the  respective  tendencies  of  these  two  parties. 

The  law,  Similia  similibus  curantur,  which  is  the  essence 
of  Homoeopathy,  was  not  an  absolute  novelty  in  medicine. 
Indeed,  Hahnemann's  first  argument  in  favor  of  it  was 
drawn  from  the  records  of  medicine.  He  showed  that,  in  all 


THE  USE   OF  HIGH   POTENCIES 


ages,  many  cures  had  been  made  in  accordance  with  it.  He 
proved  that  his  contemporaries,  often  unwittingly  and  some- 
times consciously,  applied  it  in  treating  the  sick.  To  urge 
its  admission  as  the  universal  law  of  cure  was,  therefore, 
simply  to  advocate  the  recognition,  as  a  universal  truth,  of 
that  which  was  already  received  by  medical  men  as,  at  least, 
a  truth  of  partial  and  limited  application. 

Accordingly,  the  opposition  to  Hahnemann  was,  at  the 
very  first,  moderate.  It  was  somewhat  of  the  nature  of  a 
demand  for  more  conclusive  testimony. 

Men  of  conservative  tendencies  might  very  consistently, 
at  this  time,  have  become  homoeopath  ists  ;  for  it  was  not 
unreasonable  to  anticipate,  at  some  period  in  the  not  dis- 
tant future,  a  universal  recognition  of  the  homoeopathic  law 
of  cure  and  a  consequent  reunion  with  the  dominant  power. 

But  the  dynamization  theory  was  in  irreconcilable  opposi- 
tion to  all  the  notions  of  Hahnemann's  opponents.  It  taught 
that  doses  inconceivably  small  were  sufficient  to  effect  radi- 
cal cures  in  acute  and  dangerous  diseases  —  that  such  doses 
were  even  more  efficacious  than  larger  ones.  It  taught  that 
instead  of  the  curative  power  of  the  drug  being  directly  in 
proportion  to  its  material  quantity,  there  was  reason  for 
believing  that,  to  some  extent,  at  least,  the  converse  was 
true. 

There  could  be  no  such  thing  as  a  compromise  on  this 
question.  Truth  lay  either  with  Hahnemann  or  with  his 
opponents.  It  could  not  lie  between  them.  To  maintain 
this  dynamization  theory  would  be  to  make  the  separation 
between  homceopathists  and  the  dominant  school  of  medi- 
cine perpetual  and  irremediable 

It  is  easy  to  perceive  what  sort  of  a  reception  was  likely 
to  be  accorded  to  the  dynamization  theory  by  the  Conserva- 
tive homceopathists.  They  could  not  regard  it  without 
unfavorable  prepossessions.  If  compelled  at  last  to  admit  its 
soundness,  this  would  not  be  until  irresistible  testimony  in 
its  favor  had  been  amassed  —  nor  even  then  without  regret 


IN  THE  TREATMENT  OF  THE   SICK.  233 

for  the  fact  and  deprecation  of  the  obstacles  which  it 
created  in  the  way  of  a  reunion  with  the  Old  School.  All 
their  a  priori  assumptions  would  be  unfavorable  to  its 
validity. 

The  Radicals,  on  the  other  hand,  would  receive  with  joy 
this  additional  element  of  difference  from  the  Old  School  of 
medicine.  They  would  advocate  it  with  enthusiasm.  Their 
a  priori  arguments  would  lend  it  a  vigorous  support. 

Thus  in  relation  to  a  question  that  can  be  settled  by 
experiment  alone,  and  by  a  course  of  experiment  requiring 
careful  unprejudiced  observation  through  many  successive 
years,  we  have  all  the  conditions  requisite  for  an  ardent  con- 
troversy at  the  very  outset,  before  any  valid  evidence  could 
possibly  have  been  gathered  by  either  party. 

We  shall  be  less  surprised  at  the  vigorous  opposition  to 
the  dynamization  theory,  if  we  recollect  the  condition  of 
medicine  and  pharmacy  at  the  beginning  of  the  present 
century.  The  posology  of  that  period  was  decidedly  heroic. 
Drugs  were  given  in  the  crudest  forms.  Pharmaceutical 
chemistry  had  not  yet  discovered  the  essential  principles  of 
drugs,  the  use  of  which  at  the  present  day  has  made  doses 
of  the  one-fourth,  one-eighth,  or  one-twentieth  of  a  grain 
familiar  even  to  practitioners  of  the  Old  School.  The 
microscope  was  still  a  rude  and  primitive  instrument; 
quantitative  chemical  analysis  had  not  attained  any  great 
development ;  much  less  was  there  any  thought  of  applying, 
as  is  now  done,  the  reactive  susceptibility  of  the  living 
organism  to  detect,  through  its  specific  affinities,  particles  of 
matter  so  small  as  to  elude  the  microscopist  and  the  chemist. 
In  fact  the  doctrine  of  the  extreme  divisibility  of  matter 
rested,  at  that  time,  rather  on  the  speculations  of  the  meta- 
physician than  on  the  demonstration  of  the  naturalist. 

For  this  very  reason,  on  the  other  hand,  the  speculations 
of  the  metaphysician  had  at  that  period  the  wider  scope 
and  the  greater  authority.  And  thus  it  was  very  easy  for 
some  of  Hahhemann's  more  radical  followers  to  erect  on  a 


234  THE   USE  OF   HIGH  POTENCIES 

figurative  illustration  used  by  him  in  the  Organon  a  "  cloud- 
capped  "  theory  of  the  transplantation  of  the  medicinal  force 
from  the  substance  of  the  drug  to  the  substance  of  the 
vehicle  used  for  dilution,  and  upon  the  basis  of  this  airy 
hypothesis  to  explain  all  manner  of  supposed  action  and 
reaction  of  drug-spirit  upon  diseased  force,  etc.,  etc. 

These  considerations  will,  I  think,  justify  us  in  passing 
over  with  scarcely  a  word  of  comment  all  that  was  so  copi- 
ously written  on  the  subject  of  the  dose,  from  the  date  of 
Korsakoff  s  first  publication  to  the  date  of  Dr.  Trinks'  public 
letter  to  Dr.  Stens  in  1859. 

The  principles  involved  in  the  question  of  the  efficacy  and 
advantages  of  high  potencies  are  these  : 

1.  The  curative  power  of  a  properly  selected  drug  is  not 
in  the  direct  ratio  of  the  quantity  of  the  drug. 

2.  The   process  of  potentization   which  Hahnemann  in-  ( 
vented,  develops  a  curative  power  in  substances,  which  in 
the  crude  form,  manifest  no  such  power ;  and  it  increases 
the  curative  power  of  drugs  which  in  the  crude  form  do 
manifest  a  curative  power. 

Now,  although  these  principles  had  been  satisfactorily 
established,  one  would  think,  by  the  successful  use  of  the 
third  or  sixth  potencies,  long  before  the  controversy  about 
the  "  high  potencies  "  began,  yet  it  will  be  perceived  that 
almost  all  the  objectors  who  began  to  write  after  Korsa- 
koff's  publication  and  Hahnemann's  cautious  and  conditional 
approval  of  it,  derive  their  arguments  from  considerations 
of  the  probable  quantity  of  the  drugs  which  these  high 
potencies  might  contain.  Thus  we  are  cautioned,  even  by 
those  who  admit  that  higher  potencies  have  curative  powers, 
that  they  are  not  to  be  trusted  in  acute  diseases  which  have 
a  rapid  course,  because,  as  Dr.  Scott  expresses  it,  "  in  these 
diseases  the  vital  forces  act  with  exaggerated  energy  and  to 
act  upon  them,  we  require  a  greater  amount  of  medicinal 
power,  that  is,  a  lower  dilution."  This  statement,  it  will  be 
perceived,  regards  the  curative  power  as  directly  proper- 


IN  THE  TREATMENT  OF  THE  SICK.  235 

tioned  to  the  quantity  of  the  drug,  and  begs  the  whole 
question  at  issue. 

But  when  Hahnemann  had  shown  that  a  more  efficient 
curative  power  was  exerted  by  the  first  dilution  or  tritura- 
tion,  or  even  by  drop  doses  of  the  mother  tincture  of  drugs 
than  by  massive  doses,  as  he  had  done  to  the  satisfaction  of 
all  homceopathists,  long  before  the  higher  dilutions  were 
ever  made,  he  had  demonstrated  that  the  curative  power  of 
drugs  is  not  in  the  proportion  of  their  material  quantity,  and 
had  thus  established  the  first  principle  of  the  dynamization 
theory. 

When,  furthermore,  he  showed  to  the  satisfaction  of  all 
homceopathists,  that  substances  which  in  their  crude  state 
exert  no  medicinal  power,  such  as  gold,  charcoal,  tin,  com- 
mon salt,  etc.,  etc.,  do,  after  dilution,  trituration  or  potenti- 
zation,  come  to  possess  a  medicinal  power,  he  demonstrated, 
in  part,  the  second  principle  of  the  dynamization  theory. 

These  demonstrations  removing  the  question  of  dose 
entirely  from  the  domain  of  mechanics,  in  which  power  is 
directly  proportioned  to  quantity y  left  the  whole  question 
open  for  experiment. 

The  points  to  be  determined  were  these : 

1.  The  curative  power  of  a  drug  not  being  directly  pro- 
portioned to  the  quantity  of  the  drug,  what  relation  does 
exist  between  this  power  and  quantity  ?   What  effect  does  a 
continued  diminution  of  quantity  exert  upon  the  curative 
power  of  the  drug  ? 

2.  It  being  admitted  that  the  potentization  process  does 
develop  the  curative    power,  what   are   the   limits  of  this 
development  ?     What  varieties  in  the  nature  and  extent  of 
this  developed  power  are  produced  by  various  degrees  of 
potentization  ? 

Obviously  these  questions  were  to  be  solved  only  by  a 
long  course  of  methodical  experiment. 

While  the  controversy  on  hypothetical  grounds  was 
being  carried  on  by  the  Conservative  and  Radical  homce- 


236  THE  USE   OF   HIGH    POTENCIES 

opathists,  reports  of  cases  were  accumulating  in  the  homoe- 
opathic journals,  which  furnished  indisputable  testimony  to 
the  action  of  the  higher  potencies.  Among  those  who  pub- 
lished these  records,  the  names  of  Gross,  Stapf,  Hering,  von 
Boenninghausen,  ^Egidi  and  Nunez  are  conspicuous. 

Their  testimony  was  disputed  on  various  grounds.  Against 
some  cases  it  was  urged  that  they  were  inconclusive,  since  it 
was  not  clearly  shown  that  the  cure  resulted  from  the 
remedy  given  and  not  rather  from  some  hygienic  prescrip- 
tion or  restriction  resorted  to  at  the  same  time.  Such 
criticism  is  legitimate,  and  cases  to  which  it  is  fairly  applica- 
ble must  be  excluded. 

Against  other  cases  it  was  urged  that  the  data  were  not  so 
fully  recorded  as  to  enable  the  reader  to  make  sure  of  the 
diagnosis.  I  do  not  think  such  criticism  as  this  is  admis- 
sible, unless  in  a  very  few  cases. 

The  value  and  authority  of  clinical  records  always  depend 
on  the  reputation  of  the  reporter  for  knowledge,  accuracy 
and  integrity.  Now,  whether,  in  reporting  a  case  of  alleged 
pneumonia,  the  reporter  simply  state  that  it  was  a  case  of 
pneumonia,  presenting  such  or  such  characteristic  symptoms, 
or  whether  he  present  a  minute  and  elaborate  detail  of  all 
the  rational  and  physical  signs  of  the  patient,  obtaining  by 
the  aid  of  auscultation,  percussion,  mensuration  and  chemi- 
cal and  microscopical  analysis — in  either  case,  we  have 
nothing  to  depend  upon  but  the  scientific  capacity  and  the 
integrity  of  the  observer. 

If  he  have  these  qualities  in  a  sufficient  degree  to  obtain 
with  certainty  the  requisite  physical  and  rational  signs  on 
which  to  base  a  trustworthy  diagnosis  of  pneumonia,  his 
statement  of  this  diagnosis  will  be  sufficient  without  the 
details.  If  he  have  them  not,  no  details  which  he  might 
pretend  to  give  would  be  deserving  of  the  slightest  confi- 
dence. These  considerations  annihilate  the  objection  made 
by  Dr.  Watzke  to  cases  published  by  Gross  and  Boenning- 
hausen in  the  Archiv. 


IN  "THE  TREATMENT  OF  THE  SICK.  237 

In  general,  however,  it  were  well  to  exclude,  provisionally 
at  least,  all  cases  of  doubtful  diagnosis. 

While  cases  demonstrating  the  value  and  efficacy  of  the 
high  potencies  were  accumulating,  a  few  cases  were  also 
published  in  which,,  the  higher  potencies  having  been  used 
without  effect,  a  lower  potency  or  a  crude  dose  of  the  same 
drug  effected  a  cure.  Dr.  Black  relates  that  in  a  case  of 
headache  Lachesis30  only  produced  symptoms  of  nervous  dis- 
turbance, while  Lachesis6  effected  a  cure.  Dr.  Trinks  records 
a  case  which  had  been  treated  by  Hahnemann  for  nearly  two 
years  with  Rhus  in  a  higher  dilution  without  effect,  and 
which  he  himself  cured  within  a  few  months  by  repeated 
doses  of  the  mother  tincture  of  Rhus. 

The  angry  controversy  was  brought  to  a  temporary  close 
by  Dr.  Trinks'  public  letter  to  Dr.  Stens,  in  which  he  states : 
"  I  was  born  a  skeptic.  As  to  the  wonder  cures  (cures  by 
the  high  potencies)  published  in  the  journals,  I  can  only  say, 
I  do  not  believe  a  word  of  them."  "Non  credo  quia  impos- 
sibile  est,"  seems  to  be  the  creed  of  Dr.  Trinks — the  impossi- 
bility consisting  in  a  mere  assumption,  on  his  part,  that  such 
preparations  cannot  possess  any  power.  This  same  argu- 
ment—  "non  credo" — may,  with  equal  force,  be  urged  by 
the  allopathists  against  the  first  or  third  dilutions,  which  Dr. 
Trinks  is  in  the  habit  of  using. 

The  argument  proves  too  much.  If  Dr.  Trinks  may 
dismiss  with  "  I  don't  believe  it,"  the  testimony  of  those 
who  advocate  the  high  potencies,  on  the  same  grounds  may 
these  reject  his  accounts  above  referred  to,  of  the  cases  in 
which  he  alleges  that  the  lower  potencies  were  efficacious 
where  the  higher  had  faile.d. 

But  the  opponents  of  the  high  potencies  were  not 
content  with  seeking  to  invalidate  the  testimony  of  the 
advocates  of  these  preparations.  Some  of  them  presented 
records  of  cases  in  which  they  had  made  unsuccessful  trials 
of  the  high  potencies.  Of  these,  many  were  no  doubt  made 
in  good  faith,  and  must  be  accepted  as  evidence  that  there 


238  THE   USE   OF   HIGH   POTENCIES 

are  cases  in  which  the  high  potencies  fail  to  cure.  But  the 
majority  of  these  records  are  like  those  of  Dr.  Watzke, 
referred  to  by  him,  in  the  CEsterreichische  Zeitschrift,  vol.  ii., 
where  he  says,  the  patients  on  whom  he  tried  the  high  poten- 
cies suffered  for  most  part  from  diseases  in  which  there  was 
little  reason  to  expect  a  favorable  result  from  any  remedy, 
in  whatever  dose,  for,  he  says,  they  were  cases  of  "  dis- 
solving pulmonary  tubercle,  of  fungoid  tumor  of  the  brain, 
of  cerebral  and  pulmonary  apoplexy,  of  spinal  paralysis, 
of  chronic  hydrocephalus,  valvular  insufficience  of  the  heart, 
of  fibrous  tumor  of  the  uterus,  etc.,  etc. 

Yet,  no  doubt,  Dr.  Watzke  is  one  of  those  who  would 
exclaim  against  the  unfairness  of  Andral  in  pretending  to 
test  Homoeopathy  in  the  Paris  hospital,  by  giving  a  single 
dose  of  a  homoeopathic  remedy  to  a  patient  laboring  under 
incurable  disease ! 

Dr.  Watzke  himself,  though  so  bitterly  opposed  to  the 
advocates  of  high  potencies,  is  constrained  to  state  in  his 
resume  of  the  proving  of  Natrum  muriaticum,  in  the  fourth 
volume  of  the  Austrian  Journal,  "  I  am,  alas  ! — I  say,  alas  ! 
for  I  would  much  rather  have  upheld  the  larger  doses  which 
accord  with  current  views — I  am  compelled  to  declare 
myself  for  the  higher  dilutions.  The  physiological  experi- 
ments made  with  Natrum  muriaticum,  as  well  as  the  great 
majority  of  the  clinical  results  obtained  therewith,  speak 
decisively  and  distinctly  for  these  preparations."  This  is 
strong  language  from  an  avowedly  unwilling  witness  ! 

The  conclusion  to  which  an  impartial  estimate  of  the 
evidence  concerning  the  high  potencies,  up  to  the  year  1850, 
would  lead,  is  well  and  justly  expressed  by  a  writer  in  the 
British  Journal  of  Homoeopathy,  vol.  v.,  p.  154: 

"  I.  The  high  potencies  do  act 

"  2.  They  act  sometimes  very  energetically. 

"  3.  They  often  act  curatively  with  surprising  rapidity. 

"  4.  They  sometimes  cure  where  the  lower  dilutions  have 
failed — though  the  evidence  on  this  point  is  scanty." 


IN  THE  TREATMENT  OF  THE  SICK.  239 

The  same  writer  gives  the  following  points  as  still  requir- 
ing to  be  proved : 

"  i.  That  the  higher  are  always  to  be  preferred  to  the  lower 
dilutions  ;  or  that  they  are  generally  to  be  preferred  to  them. 

"2.  That  they  will  oftener  succeed  in  curing  than  the 
lower." 

To  these  points  may  be  added  the  question  which  at  that 
time  was  still  an  open  question,  viz.,  whether  the  higher 
potencies  were  applicable  and  trustworthy  in  acute  as  well 
as  in  chronic  diseases. 

During  the  last  twelve  years  a  large  mass  of  evidence  of 
a  most  interesting  and  conclusive  character  has  been  accu- 
mulated on  this  subject.  Of  so  much  of  this  as  was  fur- 
nished by  European  observers,  I  proceed  now  to  give  a 
brief  summary.  Inasmuch  as  the  question  has  been  the 
subject  of  somewhat  earnest  personal  controversy  among 
ourselves,  and  "  scars  may  yet  be  tender,"  I  prefer  to  pass 
by,  for  the  present,  with  a  few  trifling  exceptions,  all  that 
has  been  contributed  by  American  practitioners.  I  shall 
pass  over  also  all  endeavors  that  have  been  made  to  explain 
or  to  limit  by  hypothetical  reasoning  on  physiological 
premises,  the  action  of  the  high  potencies.  The  question  is 
purely  a  practical  and  experimental  one. 

One  assumed  explanation,  however,  of  the  action  of  dyn- 
amized remedies  should  be  noticed,  inasmuch  as  it  will 
enable  us  to  state  distinctly  what  we  mean  by  a  higher 
potency. 

It  has  been  alleged^  that,  admitting  that  an  apparent  devel- 
opment of  curative  power  does  result  from  the  potentizing 
process  in  the  case  of  some  drugs  at  least,  such  as  Silex,  Gold, 
Natrum  muriaticum,  etc.,  this  is  simply  because  this  process 
renders  soluble  these  substances  which,  in  the  crude  state, 
are  insoluble,  or  that  it  reduces  the  size  of  their  particles  to 
such  an  extent  that  these  particles  are  capable  of  entering 
the  smallest  blood-vessels,  and  of  thus  coming  into  contact 
with  the  diseased  tissue  and  of  acting  directly  upon  it.  This 


240  THE   USE   OF   HIGH   POTENCIES 

curative  power  which  is  pretended  to  be  developed  by  potent- 
ization  is,  they  say,  simply  a  facility  of  action  produced  by 
minute  subdivision. 

Hypothetical  explanation  does  not  alter  facts.  If,  how- 
ever, the  above  were  the  sole  explanation  of  the  action  of 
potentized  remedies,  then  it  should  result  that  the  highest 
development  of  the  curative  power  should  be  reached  in  that 
dilution  in  which  the  particles  have  been  reduced  to  a  size 
appreciably  less  than  that  of  a  blood  corpuscle.  And, 
indeed,  this  ground  has  been  taken  by  some  writers.  Now, 
arithmetical  calculation,  as  well  as  microscopic  observation, 
fixes  upon  the  third  centesimal  dilution  as  that  in  which  the 
above  degree  of  subdivision  has  unquestionably  been 
attained.  If  this  view  were  correct,  then,  dilutions  higher 
than  the  third  should  not  display  a  curative  power;  or  if 
they  do  display  such  power,  it  should  not  be  in  any  case 
superior  to  that  of  the  third  dilution. 

Now,  if  it  should  chance  to  result  from  actual,  incontro- 
vertible experiment,  that  potencies  higher  than  the  third  do 
display,  with  rare  exceptions,  a  greater  curative  power  than 
the  third  or  lower  potencies,  this  superiority  must  be  directly 
attributable  to  the  process  of  potentization. 

I  deem  it  right,  therefore,  to  call  all  those  potencies  above 
the  grade  of  that  of  which  the  action  admits  a  mechanical 
explanation — "the  higher  potencies"  The  term  will  apply, 
in  this  view,  to  all  above  the  third  centesimal. 

In  1850  Drs.  Wurmb  and  Kasper  took  charge  of  the 
Leopoldstadt  Hospital,  in  Vienna.  Their  views  on  the 
subject  of  the  dose  were  no  secret.  *  They  had  no  faith 
whatever  in  the  higher  potencies.  They  were  physicians  of 
much  more  than  ordinary  scientific  attainments,  and  of  great 
devotion ;  and  Dr.  Wurmb,  at  least,  had  few  superiors  in  an 
exact  and  thorough  knowledge  of  materia  medica.  In  their 
"Clinical  Studies,"  published  in  1852,  they  thus  express  the 
posological  views  with  which  they  entered  on  the  charge  of 
the  Hospital : 


IN  THE  TREATMENT   OF  THE   SICK.  241 

"  We  have  given  almost  always  the  thirtieth  decimal  dilu- 
tion, and  only  exceptionally  a  higher  or  a  lower  dilution. 
*  *  We  propose  to  adhere  to  this  dilution  for  two 
years  longer,  then  to  give  another  dilution  for  an  equally 
long  period,  and  finally  to  give  for  a  similar  period  still 
another  dilution.  Such  experiments  as  these  are  indispen- 
sable to  the  solution  of  the  question  of  the  dose,  but  mani- 
festly they  are  valid  only  in  the  case  of  disease  with  regard 
to  which  the  preliminary  question,  What  can  Nature  do,  and 
what  can  Art?  has  already  been  definitely  answered,  and 
in  favor  of  the  latter?" 

Here  is  the  plan  of  an  experiment  which,  if  faithfully 
carried  out,  gives  promise  of  some  very  conclusive  data  on 
the  subject  of  the  dose.  Such  questions  as  this  require  for 
their  solution  a  multitude  of  instances  such  as  can  hardly 
be  gathered  in  private  practice.  But  a  hospital  affords  an 
appropriate  and  sufficient  field  for  their  collection.  The 
hospital  of  Dr.  Wurmb  is  the  only  one  which  has  been 
devoted  to  such  uses. 

Before  the  expiration  of  the  three  periods,  of  three  years 
each,  involved  in  the  plan  as  above  stated,  Dr.  Kasper  was 
succeeded  by  Dr.  Martin  Eidherr,  who  has  published  in 
the  (Esterreichische  Zeitschrift,  for  1862,  the  result  of  the 
ten  years'  experiment. 

It  seems  that  in  1 860  the  Austrian  Homoeopathic  Society 
of  Vienna  proposed  as  a  subject  for  consideration  the  ques- 
tion of  the  dose,  inviting  all  homceopathists  of  all  countries 
to  take  part  in  the  discussion.  A  large  number  of  responses, 
both  verbal  and  written,  were  made  to  this  invitation,  some 
of  which  are  published  in  the  Austrian  Journal,  for  1862. 
Dr.  Eidherr,  the  Editor  of  the  Journal,  remarks:  "These 
discussions  have,  as  is  well  known,  led  as  yet  to  no  positive 
result,  because  they  rest  exclusively  on  subjective  grounds. 
While  some  record  most  brilliant  cures  effected  only  by  the 
higher  dilutions,  others  narrate  similar  cases  cured  only  with 
the  lower.  Consequently,  the  society  regards  the  question 
17 


242  THE   USE   OF  HIGH   POTENCIES 

as  still  an  open  one  and  calls  for  further  communications  on 
the  subject." 

At  this  point  it  was  suggested  that  the  material  in  the 
shape  of  clinical  records  which  had  been  for  ten  years  accu- 
mulating in  the  archives  of  the  Leopoldstadt  Hospital  might, 
if  collated,  throw  some  further  light  on  the  subject. 

Dr.  Eidherr  undertook  the  task.  He  resolved  to  confine 
his  investigations  to  a  single  disease,  pneumonia  (which  by 
the  way  is  very  prevalent  in  Vienna),  for  the  reason  that  the 
diagnosis  of  this  disease  is  easy,  and  that,  by  means  of  the 
physical  signs,  its  course  and  progress  and  decline  may  be 
more  accurately  followed  and  observed  than  is  the  case  with 
many  other  acute  diseases. 

During  the  ten  years,  from  1850  to  1859  inclusive,  all  cases 
in  the  Leopoldstadt  Hospital  had  been  treated  for  the  first 
three  years  with  the  thirtieth  decimal  dilution,  for  the  second 
period  of  three  years  with  the  sixth,  and  for  the  remaining 
four  years  with  the  fifteenth  decimal  dilution.  It  was  pro- 
posed to  compare  the  results  of  the  treatment  of  pneumonia 
during  these  three  periods. 

But,  in  order  to  avoid  [a  fallacy  in  drawing  conclusions 
from  this  comparison,  it  was  necessary,  first,  to  inquire 
whether  the  Genius  Epidemicus  was  the  same  for  these  three 
periods,  or,  if  not  the  same,  how  great  an  influence,  and  in 
favor  of  which  period,  did  the  difference  exert? 

To  meet  this  preliminary  question,  Dr.  Eidherr  made  a 
study,  first,  of  those  conditions  which  favor  the  origin  and 
spread  of  pneumonia  :  and,  second,  of  the  prevalence  and 
course  of  pneumonia  in  the  great  General  Hospital  of  Vienna 
during  the  same  periods  of  time. 

The  first  section  of  his  treatise  consists  of  tabular  state- 
merits  of  the  meteorological  phenomena  of  the  decennium  in 
question,  and  of  the  relations  of  these  phenomena  to  the 
prevalence  of  pneumonia  as  observed  in  the  great  General 
Hospital  of  Vienna. 

The  second  section  comprises  short  and  succinct  accounts 


IN  THE  TREATMENT  OF  THE  SICK.  243 

of  the  cases  of  pneumonia  treated  in  the  Leopoldstadt 
Hospital  during  the  three  periods  into  which,  as  already 
stated,  the  decennium  was  divided. 

The  third  section  contains  a  statement  of  the  results  of 
the  treatment  by  the  different  dilutions  used  during  the 
three  periods  in  question,  taking  into  account  the  modifying 
influence  of  the  different  atmospheric  conditions  of  these 
periods. 

The  cases  occurring  during  the  three  periods  of  time  into 
which  the  whole  period  of  ten  years  was  divided,  are  called 
by  Dr.  Eidherr — Groups  I,  2,  3. 

Group  No.  i,  embracing  the  years  1850,  1851  and  1852, 
was  treated  exclusively  with  the  thirtieth  decimal  potency. 

Group  No.  2,  embracing  the  years  1853,  1854  and  1855, 
was  treated  exclusively  with  the  sixth  decimal  potency. 

Group  No.  3,  embracing  the  years  1856,  1857,  1858  and 
1859,  was  treated  exclusively  with  the  fifteenth  decimal 
potency. 

A  careful  estimate  of  the  different  meteorological  con- 
ditions of  these  epochs  leads  Dr.  Eidherr  to  the  conclusion 
that  during  the  first  epoch  the  atmospheric  conditions  were 
most  favorable  to  the  prevalence  and  severity  of  pneumonia, 
and  therefore  the  least  favorable  for  the  treatment ;  during 
the  second  epoch  least  favorable  for  the  spread  and  severity 
of  pneumonia,  and  therefore  the  most  favorable  for  the 
treatment. 

In  observing  and  recording  cases  of  pneumonia  in  this 
hospital,  the  physical  signs  have  always  been  carefully  noted, 
and  records  have  been  made  of  the  following  points  in  the 
history  of  each  case  : 

1.  The  seat  of  the  infiltration. 

2.  Its  duration,  reckoned  from  the  time  at  which  it  was 
first  perceived  to  the  time  at  which  it  was  noticed  that  it 
began  to  be  resolved  (?). 

3.  The  time  at  which  resolution  of  the  infiltration  began. 

4.  The  time  at  which  resolution  was  completed. 


244  THE   USE   OF   HIGH   POTENCIES 

5.  The  time  at  which  all  physical  signs  disappeared. 

6.  Duration  of  convalescence. 

The  comparison  between  the  three  groups  is  made  with 
reference  to  all  of  these  points. 

The  results  are  stated  as  follows  : 

Group  i,  treated  with  the  thirtieth  decimal  dilution  ; 

The  average  duration  of  the  infiltration  was  three 
days. 

The  average  date  of  commencing  resolution  was  the  third 
day. 

The  average  date  of  completed  resolution  was  4.9  days 
from  the  beginning. 

The  average  date  of  vanishing  of  the  physical  signs  was, 
as  concerns  the  infiltration,  7. 1  days ;  as  concerns  the  exuda- 
tion, 12.3  days  from  the  beginning. 

The  average  duration  of  convalescence  was  4.4  days. 

Group  2,  treated  with  the  sixth  decimal  dilution  during 
the  years  1853,  1854  and  1855  ; 

The  average  duration  of  the  infiltration  was  4 . 1  days. 

Resolution  began,  on  the  average,  in  3.5  days,  and  was 
complete  in  6.9  days. 

The  physical  signs  disappeared,  on  the  average,  as 
concerns  the  infiltration,  in  9.3  days;  as  concerns  the 
exudation,  in  20.5  days. 

The  duration  of  the  convalescence  was,  on  the  average, 
5.3  days. 

Group  3,  treated  with  the  fifteenth  decimal  dilution,  during 
the  years  1856,  1857,  1858  and  1859; 

The  average  duration  of  infiltration  was  3.4  days. 

Resolution  began  in  3.2  days. 

It  was  complete  in  6.3  days. 

The  physical  signs  disappeared,  so  far  as  the  infiltration 
was  concerned,  in  10.3  days;  so  far  as  the  exudation  was 
concerned,  in  18.1  days. 

Average  duration  of  convalescence,  4.8  days. 

To  recapitulate  the  above  — 


IN  THE  TREATMENT  OF  THE   SICK.  24$ 

The  average  duration  of  the  infiltration  was : 
For  Group  I,  3.0  days. 
2,4-1     " 
3,  3-0     " 

Resolution  began : 

For  Group  I,  on  the  3d  day. 

2,  "      3-5    " 

3,  "      3-2    " 
Resolution  was  complete : 

For  Group  I,  on  the  4.9  day. 

2,  "      6.9    " 

3,  "      6.3    " 
The  physical  signs  of  the  infiltration  vanished : 

For  Group  i,  on  the  7.1  day. 

2,  "      9.3    " 

3,  "    10.3    " 

The  physical  signs  of  the  exudation  vanished : 
For  Group  I,  on  the  12.3  day. 
"  2,       "       20.5    " 

"  3,       "       18.1    " 

Dr.  Eidherr  gives  also  a  tabular  statement  of  the  average 
number  of  days  during  which  each  case  of  each  group 
remained  in  hospital — that  is,  the  total  duration  of  each  case 
from  its  reception  to  its  dismissal,  as  follows : 

Group  i,  treated  with  the  thirtieth  decimal  dilution;  fifty- 
five  cases  were  treated ;  their  aggregate  residence  in  the  hos- 
pital amounted  to  680  days;  or  an  average  of  11.3  days 
each. 

Group  2,  under  the  sixth  decimal  dilution;  thirty-one 
cases,  606  days ;  an  average  of  19.5  days  for  each  case. 

Group  3,  treated  with  the  fifteenth  decimal  dilution;  fifty- 
four  cases,  and  795  days ;  an  average  of  14.6  days  for  each 
case. 


246  THE   USE   OF   HIGH   POTENCIES 

I  now  proceed  to  give  as  briefly  as  possible  the  conclusion 
to  which  Dr.  Eidherr  is  led  by  this  careful  study  of  his 
statistics.  He  says:  "This  is  the  most  extensive  experiment 
that  has  ever  been  made,  bearing  on  the  question  of  the 
dose.  Its  subjects  were  107  cases  of  pneumonia.  Each 
case  was  the  subject  of  careful  investigation.  Every 
imaginable  care  was  taken  to  obviate  every  source  of  fallacy." 
The  experimenters  were  not  radical  homceopathists.  Their 
prepossessions  were  rather  against  the  high  potencies.  I 
can  bear  personal  testimony  to  the  fact  that,  in  1851,  while 
the  thirtieth  dilution  was  the  standard  used  in  the  hospital, 
Dr.  Wurmb  frequently  expressed  himself  as  believing  that 
statistics  would  decide  in  favor  of  lower  dilutions.  It  was 
not  known  how  statistics  had  decided  until  Dr.  Eidherr 
made  the  analysis  from  which  I  have  quoted,  and  which 
shows  that  in  every  point  of  view  the  action  of  the  thirtieth 
dilution,  in  so  acute  and  dangerous  a  disease  as  pneumonia,  is 
more  certain  and  more  rapid  than  that  of  the  fifteenth  or  the 
sixth  dilution,  and  that  the  fifteenth  is  preferable  to  the  sixth 
dilution — or,  to  translate  the  decimal  into  the  centesimal 
scale,  the  fifteenth  is  better  than  the  seventh,  the  seventh 
than  the  third. 

Against  this  record  Dr.  Trinks  would  raise  in  vain  his  cry 
" non  credo" 

If  we  refer  now  to  the  points  which  were  stated  in  1850 
as  still  requiring  to  be  proved  in  relation  to  the  high  poten- 
cies, we  find  the  third  question  satisfactorily  solved  by  this 
experiment  in  the  Leopoldstadt  Hospital.  For  the  exper- 
iment proves  beyond  a  doubt,  that  the  higher  potencies  are 
applicable  and  trustworthy  in  acute  as  well  as  in  chronic 
diseases. 

It  enables  us  also  to  give  a  probable  affirmative  answer  to 
the  first  question,  and  to  say  that  the  higher  are,  at  least  so 
far  as  pneumonia  is  concerned,  to  be  preferred  to  the  lower 
dilutions. 

The  second  question,  viz.,  whether  higher  dilutions  will 


IN  THE  TREATMENT  OF  THE   SICK.  247 

oftener  succeed  in  curing  than  lower  dilutions,  is  left  unaf- 
fected by  this  great  experiment. 

Let  us  now  recapitulate  the  points  at  issue.  I  think  we 
may  safely  state  that,  up  to  the  present  time,  experience 
has  established  these  facts :  that  the  continued  diminution  of 
the  material  quantity  of  a  drug  through  the  process  of 
potentization  does  not  diminish  the  curative  power  of  the 
drug  when  homceopathically  applied ;  that,  on  the  contrary, 
the  process  of  potentization  does  positively  increase  the 
curative  power  of  a  drug  when  homceopathically  used  ;  that 
this  increase  of  curative  power  is  progressive,  as  far  at  least 
as  the  fifteenth  centesimal  dilution,  and  is  demonstrated 
in  the  treatment  of  both  acute  and  chronic  diseases. 

It  was  incumbent  on  the  advocates  of  the  higher  potencies 
to  demonstrate  not  only  that  these  preparations  are  effica- 
cious, nor  simply  that  they  are  equally  efficacious  with  the 
lower  potencies,  but  that  they  are  superior  in  efficacy. 

This  has  been  shown  by  the  Vienna  experiment  up  to  a 
certain  degree.  The  seventh  centesimal  has  been  shown  to 
be  superior  in  the  treatment  of  pneumonia  to  the  third,  and 
the  fifteenth  to  the  seventh.  There  is  a  natural  desire  to 
find  the  limit  of  potentization.  The  Vienna  experiment 
gives  us  no  reason  to  suppose  that  this  limit  has  been 
attained  in  the  fifteenth  potency. 

Many  most  eminent  practitioners  assert  for  what  are 
technically  termed  the  "high  potencies,"  as  great  a  superi- 
ority over  the  fifteenth  and  thirtieth  as  the  latter  have  been 
shown  to  possess  over  the  third.  Cases  are  accumulating  in 
our  journals  which  go  to  corroborate  these  assertions.  We 
cannot  refuse  to  believe  these  narrations.  While  they  have 
not  yet  established  a  general  superiority  of  the  "high 
potencies "  (sixtieth  to  two  hundredth)  over  the  fifteenth 
and  thirtieth  for  the  treatment  of  all  cases,  acute  and  chronic, 
they  nevertheless  prove  beyond  dispute  that  the  rapid  and 
permanent  cure  of  both  acute  and  chronic  diseases  is  within 
their  scope. 


248  THE   USE  OF  HIGH   POTENCIES 

They  establish,  moreover,  the  fact  that  in  many  cases 
these  high  potencies  (the  two  hundredth,  for  example)  cure 
diseases  in  which  the  lower  potencies  of  the  same  drug  have 
failed. 

The  determination  of  absolute  superiority  and  of  definite 
limits  of  increase  of  curative  power,  is  impossible  from  our 
present  data. 

Among  those  who  have  long  used  the  high  potencies  (in 
particular  the  two  hundredth),  Dr.  von  Bcenninghausen 
stands  pre-eminent.  It  is  true  that  his  practice  lies  chiefly 
among  chronic  diseases.  Nevertheless,  many  acute  diseases 
are  treated  solely  in  accordance  with  his  directions.  He 
has  for  many  years  used  exclusively  the  two  hundredth 
potencies.  His  increasing  fame  and  practice  attest  the 
validity  of  the  services  which  he  renders  to  those  who 
consult  him.  The  high  character  which  he  has  always 
borne  as  an  acute  and  sagacious  observer  of  natural  phe- 
nomena, the  unblemished  reputation  which  he  has  sustained 
throughout  his  long  and  eventful  life,  cause  his  observations 
and  his  statements  to  be  received  with  implicit  reliance  and 
belief  by  all  who  are  at  all  cognizant  of  his  social  position. 
He  does  not  hesitate  to  express  a  decided  conviction  of  the 
great  superiority  of  the  high  potencies  over  the  lower,  in 
both  acute  and  chronic  diseases. 

Dr.  ^Egidi,  who,  after  having,  on  their  first  introduction, 
spoken  favorably  of  the  high  potencies,  retracted  to  some 
extent  this  good  opinion,  has  recently  announced  as  the 
result  of  a  long  course  of  experiment  in  his  private  practice, 
embracing  the  history  of  more  than  4,000  cases,  a  clear  and 
unequivocal  preference  for  the  high  potencies  in  both  acute 
and  chronic  diseases. 

Dr.  Battman  has,  within  the  last  two  years,  published  a 
series  of  cases  of  severe  membranous  croup,  and  of  very 
dangerous  acute  pulmonary  affections,  cured  in  a  marvelous 
manner  with  the  two  hundredth  potency;  and  basing  him- 
self on  these  narrations,  he  makes  a  warm  protest  against 


IN   THE   TREATMENT   OF   THE   SICK.  ,249 

the  irrational  conduct  of  those  homceopathists  who,  at  the 
same  time  that  they  object  to  the  illogical  conduct  of  the 
allopathists  in  refusing  even  to  listen  to  any  evidence  in 
favor  of  Homoeopathy,  obstinately  close  their  own  ears  to 
all  that  is  alleged  in  behalf  of  the  high  potencies. 

Of  six  physicians  of  Austria  and  Hungary  who  presented 
written  essays  on  the  question  of  the  dose  to  the  Vienna 
society,  none  denied  the  curative  action,  often  prompt  and 
surprising,  of  the  high  potencies  (one  hundredth  to  the  three 
hundredth)  in  both  acute  and  chronic  diseases.  Only  one 
expressed  a  doubt  that  they  were  in  any  case  superior  to  the 
lower  potencies.  Two  did  not  hesitate  to  claim  such  superi- 
ority for  them  in  decided  terms. 

Dr.  Wurmb,  the  head  of  the  Leopoldstadt  Hospital,  states1 
that  often  remedies  in  the  higher  dilutions  act,  where  the 
lower  dilutions  of  the  same  remedy  had  failed  to  act.  He 
gives  an  instance  in  which  Belladonna100  effected  a  cure  in 
chronic  migraine,  in  which  a  lower  potency  of  the  same 
remedy  had  failed  to  do  any  good.  The  one  hundredth  and 
two  hundredth  potencies  are  now  not  infrequently  adminis- 
tered in  the  Leopoldstadt  Hospital.  Dr.  Wurmb  remarks2 
that  "  since  he  has  had  experience  with  the  one  hundredth 
dilution  prepared  by  Dr.  Eidherr,  and  has  satisfied  himself 
of  the  wonderful  effects  which  often  result  from  them,  he 
prescribes  them  in  suitable  cases  with  greater  preference  than 
the  thirtieth  or  any  other  potency."  He  does  not  state 
what  he  considers  to  be  "suitable  cases."  It  is  probable 
that  he  does  not  consider  his  experience  to  be  great  enough, 
as  yet,  to  justify  him  in  laying  down  any  general  rules  on 
the  subject.  It  is  likely  that  he  decides  for  each  particular 
case,  according  to  his  view  of  probabilities,  and  that  he 
cannot  always  give  a  clear  reason  for  his  preference  of  one 
potency  over  another.  Each  case  thus  treated  may  be 
regarded  as  in  some  sort  an  experiment — a  contribution  to 
that  multitude  of  instances  from  an  analysis  of  which  we 
1  (Est.,  Zeit.,  I.  158,  1862.  *  Loc.  cit.  3,  p.  137. 


250  THE   USE   OF   HIGH   POTENCIES 

may  hope  to  deduce,  at  some  future  time,  a  general  law  of 
posology. 

If,  after  this  general  view  of  the  evidence  on  the  subject 
of  the  high  potencies,  it  be  appropriate  for  me,  on  such  an 
occasion  as  the  present,  to  state  my  own  experience  and 
methods,  it  may  be  done  very  briefly. 

Before  I  had  fairly  entered  to  any  great  extent  upon  the 
responsibilities  of  the  practice  of  medicine,  I  had  the  advan- 
tage of  observing  the  practice  of  some  very  eminent  physi- 
cians and  of  listening  to  the  counsel  of  others. 

Not  to  mention  American  physicians,  I  heard  in  England 
chiefly  the  advocates  of  the  low  and  the  lowest  potencies. 
The  high  potencies  were  at  that  time  rarely  mentioned  in 
England  except  in  terms  of  ridicule.  And  the  contempt 
which  the  assumed  non-material  nature  of  these  potencies 
inspired  in  the  matter-of-fact  mind  of  that  taurine  nation- 
ality, whose  devotion  to  the  pound  avoirdupois  is  even 
greater,  if  that  were  possible,  than  to  the  pound  sterling, 
was  cordially  extended  to  the  intellectual  acuteness  and  the 
scientific  acquirements  of  all  who  believed  in  these  potencies 
and  who  used  them.  Since  that  period  the  cause  of  the  high 
potencies  has  been  nobly  advocated  in  England,  by  a  few  of 
those  strong  men,  who  are  the  true  glory  of  the  nation. 

Passing  from  England  to  Westphalia,  I  enjoyed  free  and 
full  and  long-continued  opportunities  to  observe  the  practice 
of  Dr.  von  Boenninghausen,  who  used  the  two  hundredth 
potency  exclusively.  There  was,  certainly,  in  his  practice, 
less  parade  of  scientific  auxiliaries  than  I  had  seen  at  the 
English  hospitals  or  in  the  English  dispensaries  ;  but  I  do  not 
think  the  diagnosis  was  less  accurate  on  that  account.  I  am 
very  sure  that  the  success  of  the  treatment  left  but  little  to 
be  desired.  Though  some  acute  diseases  were  here  treated 
with  high  potencies  under  my  observation,  yet  the  majority 
were  chronic  cases,  and,  deeply  impressed  with  the  great 
responsibility  involved  in  my  judgments,  I  was  hardly  ready, 
from  these  observations,  to  conclude  on  the  advantage  of 


IN  THE  TREATMENT   OF  THE  SICK.  2$  I 

using  high  potencies  in  a  general  practice.  Nevertheless, 
the  effect  of  these  observations  was  such  as  to  satisfy  me  of 
the  efficacy  of  the  higher  potencies  in  all  forms  of  diseases. 
The  question  remained,  "Are  they  superior  to  the  lower?" 
Stapf,  who  was  then  living  in  retirement,  counseled  me  to 
use  the  high  potencies  in  chronic  diseases,  and  thought  the 
medium  potencies  were  all  that  could  be  desired  in  acute 
diseases.  He  had  no  statistics  of  comparative  observations 
by  which  to  justify  his  opinions. 

In  Vienna,  Wurmb  and  Kaspar  were  in  the  middle  of  the 
first  epoch  of  the  decennium  of  which  Eidherr  has  given  us 
the  analysis.  They  were  treating  all  diseases  with  the  thir- 
tieth decimal  dilution.  Their  examinations  of  patients  were 
minute  and  masterly,  their  prescriptions  careful,  their  suc- 
cess very  striking. 

Fleischmann,  at  the  same  time,  was  giving  the  mother 
tincture  or  the  lowest  dilutions.  His  diagnosis  was  careless, 
his  success  neither  rapid  nor,  except  as  compared  with  heroic 
allopathic  treatment,  very  striking.  His  prescriptions  were 
not  accurate.  He  did  not  individualize  his  cases,  but  pre- 
scribed according  to  a  coarse  and  rude  generalization.  On 
the  subject  of  the  potency,  his  opinions,  I  learned  from  him- 
self, were  immovably  made  up.  I  perceived  that  he  had 
ceased  to  be  capable  of  learning,  although  he  still  lived ;  that, 
in  knowledge,  as  in  stature,  he  had  attained  his  growth; 
ossification  was  complete  in  his  perceptive  intellect  no  less 
than  in  his  physical  skeleton. 

In  Paris,  Tessier  was  treating  acute  diseases  in  the  hospital 
Ste.  Marguerite  with  the  sixth,  twelfth  and  fifteenth  dilu- 
tions. His  success  exceeded  that  of  Fleischmann.  It  was 
inferior  to  that  of  Wurmb,  but  it  was  easy  to  perceive  how 
inferior  he  was  to  that  excellent  physician  in  minute  and 
comparative  knowledge  of  the  materia  medica. 

In  Paris,  Dr.  Perry  was  prescribing  at  his  dispensary  the 
two  hundredth  potency,  with  but  few  exceptions,  in  all  forms 
of  disease.  The  reports  indicated  a  very  wonderful  success, 


252  THE   USE  OF   HIGH   POTENCIES 

but,  from  the  nature  of  a  dispensary  practice,  this  could  not 
be  made  the  subject  of  exact  observation. 

My  conclusions  from  all  these  observations  were  favorable 
to  the  high  potencies,  so  far  as  to  admit  their  energetic  action 
on  acute  as  well  as  chronic  diseases  and  their  general  supe- 
riority in  the  treatment  of  the  latter ;  but  I  was  not  satisfied 
that  they  were  so  trustworthy,  as  a  general  rule,  in  the  treat- 
ment of  acute  diseases  as  to  be  preferable  to  the  lower  poten- 
cies. I  therefore  began,  in  my  own  practice,  with  the  use  of 
the  lower  and  medium  dilutions  (third  to  twelfth  and 
fifteenth)  in  acute  diseases.  When  very  sure  that  my 
selection  of  the  remedy  was  entirely  correct  and  that  the 
case  would  not  suffer  should  my  first  prescription  prove 
inert,  I  ventured,  during  the  first  few  years  of  my  practice,  to 
give  a  high  potency  in  acute  diseases.  I  now  look  back  on 
this  period  with  wonder  that  the  idea  of  a  definite  and  direct 
relation  between  the  curative  power  and  the  material 
quantity  of  a  drug  should  have  been  so  hard  to  eradicate 
from  my  mind. 

Experience  of  the  action  of  the  higher  potencies,  on  my 
own  person,  in  very  acute  illness,  first  fully  convinced  me — 
perhaps,  because,  in  my  own  case  I  took  the  risk  of  trying 
the  experiment  more  freely  and  fully  than  I  had  ever  done 
in  the  case  of  others. 

For  the  last  five  years1  I  have  used  the  high  potencies 
(two  hundredth  of  my  own  manufacture  and  of  Lehrmann's, 
indiscriminately)  in  all  forms  of  disease  that  occur  in  a 
general  practice.  I  am  very  sure  that  my  practice  has 
grown  more  successful  every  year.  While  I  trust  that  an 
increasing  knowledge  of  the  Materia  Medica  may  have  con- 
tributed greatly  to  this  result,  I  cannot  be  mistaken  in  the 
belief  that  much  is  also  due  to  my  more  and  more  frequent 
use  of  the  high  potencies. 

I  cannot  say  that  every  prescription  has  done  everything 
I  expected  or  hoped  from  it.  Nobody's  practice  can  be 

1  Written  in  1863. 


IN  THE   TREATMENT   OF   THE   SICK.  253 

free  from  painful  failures.  In  such  cases,  wherever  I  have 
been  tolerably  sure  that  my  choice  of  remedy  was  correct,  I 
have  repeated  the  same  remedy  in  a  higher  or  lower  potency 
as  the  case  might  be,  and  while  I  have  collected  from  my 
practice  many  instances  in  which  a  high  potency  has  acted 
promptly  where  a  low  had  failed  to  act,  I  have  noted  only 
one  case  in  which  a  high  potency  acted  but  inefficiently 
while  a  lower  gave  prompt  and  complete  relief. 

From  my  own  experience,  then,  the  presumption  would 
lie  in  favor  of  the  high  potencies  in  both  acute  and  chronic 
diseases. 

A  few  instances  will  serve  to  illustrate  what  has  been  said. 
They  are  presented  only  as  illustrations,  by  no  means  as  the 
evidence  on  which  my  convictions  rest. 

A  gentleman  who  had  suffered  many  years  from  necrosis 
of  the  femur  was  subject  to  acute  attacks  of  periostitis.  The 
twelfth  potency  of  Asafoetida  was  found  to  relieve  his 
suffering,  and  repeated  doses  of  it  generally  effected  a  cure 
within  three  or  four  days.  '  After  treating  several  attacks  in 
this  way,  I  gave  him,  at  the  commencement  of  a  fresh  attack, 
a  dose  of  Asafcetida200.  The  cure  was  effected  in  the  space 
of  six  hours.  A  difference  so  remarkable  was  very  obvious 
to  the  patient,  who,  learning  from  me  the  difference  between 
this  and  my  former  prescriptions,  requested  to  be  treated 
always  thereafter  with  the  two  hundredth.  Here,  whatever 
cavils  may  be  raised  about  the  diagnosis  or  other  points,  the 
fact  remains  incontestable,  that  attacks  which  required  for 
their  cure  several  days  and  repeated  doses  of  Asafcetida12, 
were  cured  in  six  hours  by  a  single  dose  of  the  two 
hundredth.  Could  it  be  that  repeated  treatment  of  these 
attacks  had  modified  their  severity,  and  that  the  ameliora- 
tion chanced  to  coincide,  in  point  of  time,  with  the  change 
of  potency  ?  To  satisfy  myself  on  this  point,  I  once  reversed 
the  experiment,  and  without  my  patient's  knowledge  gave 
the  twelfth  instead  of  the  two  hundredth  potency.  The 
attack  came  on  with  its  ancient  severity  and  persistence, 


254  THE    USE    OF   HIGH   POTENCIES 

much  to  my  patient's  disgust,  who  was  abundantly  satisfied 
with  the  high  potency,  but  much  ashamed  of  my  want  of 
confidence. 

Even  after  I  had  become  quite  satisfied  of  the  superiority 
of  high  potencies  in  most  acute  diseases,  I  yet  hesitated  to 
employ  them  in  a  malady  so  fearful  and  so  rapid  as  croup. 
In  this  I  still  adhered  to  the  low  (the  third)  dilutions  of 
Aconite,  or  Spongia,  or  Hepar,  as  the  case  might  require,  or 
to  the  watery  (first  centesimal)  dilution  of  Bromium  or 
Iodine,  if  these  remedies  were  indicated.  Notwithstanding 
I  had  actually  witnessed  most  surprising  success  in  Dr.  von 
Bcenninghausen's  practice  with  the  two  hundredth  potencies 
in  severe  croup,  I  hesitated  to  use  them.  I  argued  to 
myself:  "These  low  potencies  have  served  me  well.  The 
majority  use  them.  I  do  not  know  that  the  high  are  better, 
even  if  they  be  as  good.  The  success  with  them  may  be 
exceptional.  I  dare  not  risk  the  loss  of  time  which  would 
accrue  from  an  unsuccessful  experiment  with  them." 

Thus  it  turned  out  that  I  never  used  the  high  potencies 
until,  three  years  ago,  in  the  most  severe  case  of  membran- 
ous croup  I  ever  saw,  the  low  potencies  in  which  I  had 
always  trusted  failed  me  utterly,  and  I  knew  not  what  else 
to  do.  A  resort  to  the  use  of  the  two  hundredth  potencies 
of  Aconite,  Hepar  sulphuris  and  Spongia  saved  my  patient 
from  this  extremity  of  danger,  and  satisfied  me  that  a  trial 
of  the  high  potencies  in  the  outset  of  an  attack  of  croup, 
instead  of  involving  a  risk  of  wasting  time,  does  in  truth 
obviate  such  a  risk  from  the  employment  of  the  lower 
potencies.  From  this  time  on,  in  the  treatment  of  croup,  I 
have  uniformly  begun  with  the  two  hundredth  potency  of 
whatever  remedy  was  indicated.  My  success  has  been  more 
uniform  and  much  more  rapidly  attained  than  ever  before. 

My  first  use  of  a  high  potency  of  Bromine  was  accidental. 
Called  to  prescribe  for  a  severe  case  of  croup,  in  which  that 
remedy  was  indicated,  I  found  that  the  crude  substance  or  a 
low  dilution  was  not  to  be  obtained.  I  had  the  two 


IN  THE  TREATMENT  OF  THE  SICK.  255 

hundredth  potency  in  my  pocket-case.  I  gave  it  with  a 
result  equally  happy,  and  much  more  speedy  than  I  had 
ever  before  witnessed.  This  was  altogether  contrary  to  my 
preconceived  notions  concerning  Bromine,  and  it  summarily 
upset  a  very  pretty  chemical  theory  I  had  formed. 

As  already  remarked,  I  have  sometimes  met  with  facts  of 
a  contrary  significance.  In  a  case  of  chronic  asthma,  of 
great  severity,  I  have  recently  found  Glonoine  of  the  greatest 
service.  I  first  prescribed  the  sixth  potency,  having  no 
other  at  hand.  When  the  action  of  this  dose  was  exhausted 
I  gave  the  two  hundredth.  The  result  was  by  no  means 
satisfactory.  The  sixth  again  produced  happy  effects  as 
before.  Repeated  experiments  of  this  kind  convinced  me 
that  in  this  instance  the  high  potency  did  not  act  so  favor- 
ably or  so  efficiently  as  the  low.  Whether  this  peculiarity 
should  be  accounted  for  by  assuming  an  idiosyncrasy  on 
the  part  of  the  patient,  or  a  peculiarity  of  Glonoine  which 
renders  it  incapable  of  high  potentization,  or  whether  the 
action  of  the  Glonoine  in  this  case  will  prove  to  have  been 
only  palliative,  and  therefore  temporary,  is  a  question  which 
can  only  be  solved  by  a  wider  experience  than  I  possess  in 
the  use  of  various  potencies  of  this  new  but  valuable 
remedy.1 

But  this  fact  that  a  low  potency  succeeded  where  a  higher 
had  failed,  together  with  similar  facts  reported  by  other  prac- 
titioners, must  have  a  bearing  upon  general  conclusions. 

In  conclusion,  I  think  the  following  statements  are  war- 
ranted : 

I.  In  prescribing,  the  first  essential  is  the  correct  choice 
of  the  remedy.  The  second  point — which  is  also,  in  many 
cases,  though  not  always,  essential — is  the  judicious  choice 
of  the  potency. 

'The  subsequent  history  of  this  case  recurred  with  its  original  severity,  and 

confirms  the  suspicion  that  the  great  no  form  of  Glonoine  (nor  of  any  other 

relief  afforded  by  Glonoine  was  pallia-  remedy  that  I  tried)  availed  to  give 

tive.     After  a  few  months  the  disease  relief. 


256  THE   USE   OF  HIGH   POTENCIES. 

2.  That,  in  both  acute  and  chronic  diseases,  the  prefer- 
ence, other  things  being  equal,  is  to  be  given  to  the  higher 
over  the  lower  potencies.     The  experience  of  Wurmb  shows 
that,  in  severe  pneumonia,  the  fifteenth  is  to  be  preferred  to 
the  seventh  and  the  seventh  to  the  third  (centesimal).     I 
should  go  further  and  say  that,  in  general,  preference  should 
be  given   to  still   higher  potencies,  even  to  the  two  hun- 
dredth. 

3.  Experience  shows  that,  while  the  majority  of  cases, 
both  acute  and  chronic,  are  cured  more  speedily  by  the  high 
than  by  the  lower  potencies,  yet,  in  some  cases,  the  converse 
is  observed.     No  explanation  of  this   difference  has  been 
discovered,  nor  can  its  occurrence  be  foreseen  in  any  case. 
While  therefore  the  presumption,  in  every  case,  being  in 
favor  of  the  high  potencies,  the  treatment  should  be  begun 
with  them,  nevertheless,  should  no  favorable  result  ensue, 
recourse  should  be  then  had  to  lower  potencies,  provided 
always  there  be  a  reasonable  certainty  that  the  remedy  has 
been  rightly  selected. 

4.  The  question,  whether  the  "  high  potencies  "  are  more 
generally  successful  than  the  lower,  and  in  what  proportion 
they  are  so,  is  yet  to  be  determined  by  statistics  drawn  from 
methodical  experiment. 

5.  A  general  law  for  the  a  priori  selection  of  the  potency 
suitable  for  a  concrete  case,  if  such  a  law  be  possible,  is  yet 
to  be  discovered 


REPLY  TO  A  LETTER  ON  HIGH  POTENCIES. 


The  questions  contained  in  the  following  letter,  recently 
received,  represent  a  class  of  queries  that  are  frequently 
propounded  both  orally  and  in  correspondence.  It  has 
appeared  not  inappropriate  to  publish  a  general  reply  to 
these  and  similar  questions  : 

"  i .  In  what  form  do  you  use  these  potencies,  in  the  shape 
of  pellets  or  liquids? 

"  2.  Do  you  use  the  decimal  or  the  centesimal  scale  in  the 
preparation  of  the  high  potencies  ? 

"3.  Do  you  repeat  the  high  potencies  in  rapid  succession 
in  acute  diseases,  as  you  do  the  low  preparations  ? 

"4.  If  you  use  pellets,  do  you  consider  them  perfectly 
reliable  ?  and  how  many,  as  a  general  rule,  constitute  a  dose, 
either  dry  or  taken  in  water  ? 

"5.  Do  you  alternate  the  high  potencies,  or  do  you  rely 
upon  the  single  remedy  ? 

"6.  Do  you  believe  that  the  high  potencies,  from  your 
own  experience  in  the  use  of  them  and  from  what  you  have 
beheld  in  the  practice  of  others,  are  far  superior,  in  all 
respects,  to  the  low  preparations  as  remedial  agents  ? 

"Some  of  these  questions  may  seem  in  themselves  to  be 
insignificant,  but  I  do  not  consider  them  so,  for  in  making 
my  first  >  trial  I  wish  to  start  right,  that  the  experiment 
may  be  made  fairly,  with  a  sincere  desire  to  know  the  truth, 
the  whole  truth,  and  nothing  but  the  truth. 

"  In  conclusion,  let  me  say  that  you  may  rest  assured  your 
answers  to  this  communication  will  be  kept  perfectly  private, 
and  no  publicity  (as  coming  from  you)  given  them. 

"Permit  me  to  repeat  that  it  is  only  a  sincere  desire  to 
18 


258  REPLY   TO    A   LETTER 

seek  out  and  find  the  truth  that  has  led  me  thus  to  trouble 

you." 

We  heartily  respect  our  correspondent's  earnest  desire  to 
get  at  the  "whole  truth,"  and  to  "start  fair"  in  his  experi- 
ment; and  we  respect  his  hesitation  to  use  the  high  potencies 
until  he  should  have  a  reasonable  assurance  that  in  so  doing 
he  would  not  be  hazarding  the  interests  of  his  patients.  We 
take  this  public  manner  of  replying  to  his  questions,  partly 
with  a  view  of  convincing  him  that  we  have  no  wish  that  our 
"answers  to  this  communication"  should  be  "kept  strictly 
private."  On  the  contrary,  we  should  be  glad  to  have 
"publicity  (as  coming  from  us)  given  them."  For  they  are 
expressions  of  our  honest  convictions,  the  result  of  as  careful 
observations  and  as  cautious  and  complete  experiments  as 
we  have  up  to  the  present  time  been  capable  of  making. 
They  express  our  present  opinion, — those  views  in  accord- 
ance with  which  we  shape  our  daily  practice. 

But  we  hold  ourselves  bound  by  them  only  so  long  as 
they  shall  continue  to  be  our  honest  convictions.  Should 
further  observation  and  more  extended  experience  satisfy  us 
that  any  of  our  present  positions  are  untenable  we  shall 
gladly  abandon  them  for  others,  and  shall  then,  likewise,  be 
not  only  willing  but  anxious  to  have  "  publicity  (as  coming 
from  us)  given "  to  these  new  views.  The  object  of  our 
professional  life  is  to  find  out  the  truth  and  to  shape  our 
practice  accordingly.  Consistency  to  this  object  is  true 
consistency ;  while  consistency  to  any  form  of  opinion  or 
doctrine  that  may  at  one  time  have  been  supposed  to  be  the 
truth  and  proclaimed  by  us  as  such, — consistency  to  such 
opinion  merely  because  we  may  have  once  publicly  uttered  it, 
—  this  is  the  basest  and  most  ignoble  bigotry  and  cowardice. 

In  the  article1  to  which  our  correspondent  refers,  we  had 
no  object  but  to  express  frankly  and  plainly  the  views  which 
govern  us  in  the  practice  of  medicine.  We  would  call  his 
attention  to  the  fact  that  the  greater  part  of  the  article 

1  "  The  Use  of  High  Potencies  in  the  Treatment  of  the  Sick." 


ON  HIGH   POTENCIES.  259 

consisted  of  citations  of  the  opinions  and  experiences  of  other 
practitioners  whose  conclusions  were  but  corroborated  by 
our  own. 

I.  In  what  form  do  you  use  these  potencies,  in  the  shape  of 
pellets  or  of  liquids  ? 

As  a  matter  of  fact,  we  use  them  in  the  form  of  pellets. 
As  a  matter  of  faith,  we  know  no  difference  between  pellets, 
pills,  triturations  or  liquids.  The  pellet  is  merely  a  conven- 
ient means  for  dividing  a  drop  of  liquid  into  a  number  of 
equal  parts,  and  it  is  for  this  object  that  we  use  them.  We 
have  been  in  the  habit  of  buying  unmedicated  pellets  or 
globules  at  Smith's  Pharmacy,  and  medicating  them  with 
liquid  potencies  of  our  own  preparation.  Pellets  thus  medi- 
cated we  find  retain  their  remedial  powers  for  several  years 
at  least, —  exactly  how  long  we  cannot  say.  They  are  so 
much  more  portable  and  more  convenient  to  administer  than 
liquids,  that  this  furnishes  us  a  sufficient  reason  for  preferring 
them  to  the  liquid  form  of  prescriptions.  A  writer  in  the 
British  Journal  of  Homoeopathy,  some  years  ago,  published 
an  essay  on  the  Globule  versus  the  Pillule,  making  out  a 
very  bad  case  for  the  unlucky  globule  as  calculated  to  bring 
Homoeopathy  into  contempt  in  the  eyes  of  persons  not  indoc- 
trinated. There  is  something  laughable,  if  it  were  not 
deplorable,  in  this  argument,  the  pith  of  which  is  this:  "We 
give  small  doses,  to  be  sure,  but  let  us  not,  by  using  the 
pellet,  appear  to  give  small  ones ;  let  us  use  as  big  a  pill  as 
anybody  that  we  may  not  seem  to  give  a  small  dose,  and 
may  not  rudely  jostle  the  prejudices  of  our  patients." 
But  surely,  if  contempt  would  have  damaged  Homoeopathy, 
this  luckless  science,  despised,  scorned,  ridiculed,  and,  scores 
of  times,  extinguished  by  Homeric  laughter,  should  have 
been  done  for  long  ago !  To  adopt  and  defend  this  much 
contemned  science,  and  yet  to  shrink  from  the  obvious 
smallness  of  a  pellet- dose — is  not  this  "to  strain  at  a  gnat 
and  swallow  a  camel." 

Nothing  will  gain  the  confidence  of  a  patient  so  surely  as 


26O  REPLY   TO   A    LETTER 

success  !  His  confidence,  once  gained  by  success,  cannot  be 
shaken  by  the  form  of  your  dose !  Yes,  it  may  though !  If 
he  sees  that  while  your  doctrines  require  you  to  give  small 
doses,  you  yet  dissemble  and  juggle,  and,  by  using  large 
pills  and  lozenges  and  mixtures,  try  to  make  it  appear  that 
you  are  giving  as  large  doses  as  your  Old-School  neighbor, 
he  will  suspect  that  your  faith  in  the  system  you  profess  is 
not  really  strong,  and  he  will  have  doubts  of  both  you  and 
your  system.  The  sick  man  who  feels  that  you  are  curing 
him,  cares  not  a  straw  for  the  logical  improbabilities  of  your 
doctrines,  nor  for  the  scientific  difficulties  attending  the  expla- 
nation of  the  action  of  your  little  dose.  Large  or  small, — 
much  or  nothing, —  if,  under  your  auspices,  his  health  return, 
he  will  have  faith  equally  in  yourself  and  in  your  methods. 

We  have  been  amazed  at  much  that  has  been  said  and 
written  on  this  subject.  Our  own  patients  have  rarely 
remarked  upon  the  pellet.  One,  who  had  never  seen  them 
before,  once  said  to  us,  "  Do  you  really  hope  to  cure  me 
with  those  tiny  pills?"  "Yes,  certainly."  "I  should  not 
believe  they  could  possibly  have  any  power."  "Why? 
Because  they  are  so  fine  and  small  fpr  pills?"  "Yes." 
"Then,  my  dear  sir,  instead  of  regarding  them  as  'fine 
pills?  consider  them  to  be  very  coarse  granular  powder,  and 
you  cannot  fail  to  be  impressed,  a  priori,  with  their  immense 
power!"  He  perceived  the  absurdity  of  his  objection, 
which  was  to  the  outward  form  and  not  to  the  inherent 
power.  The  success  of  the  prescription  satisfied  him  of  the 
virtue  of  little  pills. 

Another  patient  objected  to  the  very  small  vials  of  my 
pocket- case.  I  replied  they  were  a  matter  of  convenience 
to  me,  but  if  he  would  be  better  satisfied  I  would,  next  day, 
bring  his  dose  in  a  quart  bottle  and  pour  out  the  same  quan- 
tity (pellets).  He  also  perceived  that  his  objection  was 
frivolous,  and  was  content. 

2.  Do  you  use  the  decimal  or  centesimal  scale  in  the  prepa- 
ration of  the  high  potencies? 


ON   HIGH  POTENCIES.  26 1 

As  a  matter  of  fact,  we  use  the  centesimal  scale  in  prepar- 
ing the  high  potencies  and  all  the  potencies  which  we  use, 
and  have  used  since  we  began  to  practice  medicine.  As  a 
matter  of  opinion  we  see  no  reason  to  prefer  the  decimal. 
It  does  not  insure  a  more  uniform  gradation  as  has  been 
claimed.  The  use  of  it  leads  to  confusion  and  is  to  be 
regretted.  We  prefer  adhering  to  Hahnemann's  scale.  It 
is  easy  to  convert  the  one  into  the  other  in  reporting  cases 
or  in  reading  reports.  If  our  correspondent  will  refer  to  the 
article  which  prompted  his  letter,  he  will  note  that  in  the 
treatment  of  pneumonia  Wurmb  and  Eidherr  used  potencies 
prepared  on  the  decimal  scale,  which  fact  we  there  stated 
and  we  reduced  their  numbers  to  the  corresponding  ones  of 
the  centesimal  scale.  In  general  in  this  country  where  the 
facts  are  not  specifically  stated,  it  is  understood  that  the 
centesimal  or  Hahnemann  scale  is  intended. 

Our  own  preparations  were  made  in  strict  accordance  with 
Hahnemann's  directions  and  so  are  the  high  potencies  of 
Lehrmann,  as  we  have  learned  from  Dr.  von  Bcenninghausen, 
who  directed  their  preparation,  and  from  Lehrmann,  himself. 

3.  Do  you  repeat  the  high  potencies  in  rapid  succession  in 
acute  diseases,  as  you  do  the  low  preparations? 

How  shall  such  a  knotty  question  be  unraveled  ?  It 
involves  two  assumptions,  two  beggings  of  the  question, 
viz. :  i.  That  we  do  repeat  the  low  potencies  in  rapid  suc- 
cession in  acute  diseases;  and,  second,  that  we  make  any 
such  distinction  between  acute  and  chronic  diseases,  as  to 
admit  of  a  radical  difference  in  our  principle  of  prescribing. 

i.  We  recognize  but  one  rule  touching  the  repetition  of 
the  dose.  It  was  laid  down  by  Hahnemann  and  is  as 
follows :  Do  not  repeat  the  dose  of  the  remedy  given  until 
the  effects  of  the  previous  dose  shall  have  ceased  to  be 
evident.  Our  most  grievous  failures  have  come  from  a  vio- 
lation of  this  rule.  Our  most  brilliant  and  complete  suc- 
cesses have  coincided  with  a  strict  observance  of  it.  If  we 
are  sure  that  our  remedy  has  been  rightly  selected,  we 


262  REPLY   TO   A   LETTER 

sometimes  direct,  particularly  in  cases  that  have  been  actively 
treated  by  allopathic  physicians  before  we  were  called,  and  in 
which  we  apprehend  a  sluggish  response  to  remedies,  a 
repetition  of  the  dose  every  few  hours,  until  some  ameliora- 
tion or  decided  aggravation  appear,  but  we  always  order  a 
suspension  of  the  remedy  as  soon  as  either  is  manifest. 

2.  We  know  of  no  clear  distinction  between  acute  and 
chronic  diseases  on  which  to  base  a  difference  in  treatment. 
Indeed  no  difference  whatever,  unless  it  be  one  analogous 
to  that  which  Hahnemann  laid  down,  viz.  :  that  chronic 
diseases  are  based  on  the  awakening  of  miasms  that  had 
hitherto  lain  dormant  in  the  system. 

For  instance,  is  scarlatina  an  acute  disease  ?  Assuredly  it 
is  so  regarded.  Yet,  on  the  third  day,  scarlatina  often  shows 
that  it  has  awakened  and  ingrafted  itself  upon  the  scrofulous 
(or  psoric  ?)  taint  in  the  patient's  constitution  and  then, 
surely,  it  becomes  typically  chronic.  This  is  an  example 
of  what  we  see  happen  in  all  forms  of  disease.  It  prevents 
an  available  distinction  between  acute  and  chronic  diseases. 

We  can  assure  our  correspondent  that  it  is  safe  and 
advantageous  to  strictly  follow  the  Hahnemannian  rule 
about  the  repetition  of  the  dose  in  acute  no  less  than  in 
chronic  diseases.  But  let  us  anticipate  a  possible  confusion 
in  his  mind.  Some  writers — Dr.  Drysdale  we  are  surprised 
to  see  among  them  —  seem  to  think  that  Hahnemann,  when 
he  said,  "  Wait  till  the  first  dose  shall  have  exhausted  its 
action,"  meant  to  say,  "Do  not  repeat  the  dose  until  that 
period  shall  have  elapsed  which  I  have  indicated  in  the 
Materia  Medica  as  the  duration  of  action  of  each  drug." 
This  period  for  some  drugs  is  several  days,  for  others  several 
weeks  or  even  months.  We  do  not  so  understand  him. 
The  duration  of  action  of  a  remedy  on  the  healthy  subject 
(prover)  furnishes  no  criterion  of  the  duration  of  its  action 
on  the  sick.  Again,  the  duration  of  its  action  on  one  sick 
person  furnishes  no  criterion  of  the  duration  of  its  action  on 
another  sick  person.  Surely  the  vital  processes  are  much 


ON   HIGH  POTENCIES.  263 

more  rapid  in  acute  pneumonia  than  they  are  in  tubercu- 
losis. Is  it  not  probable  that  the  duration  of  action  of  a 
dose  of  medicine  would  be  shorter  in  the  former  than  in 
the  latter  ? 

We  suppose  Hahnemann  meant  as  follows :  "  If  ameliora- 
tion follows  a  dose  of  medicine,  do  not  repeat  the  dose  until 
the  amelioration  ceases  to  progress,  Then,  if  the  symptoms 
be  the  same  as  before,  though  mitigated  in  severity,  repeat 
the  dose.  If  the  symptoms  be  different,  study  the  case 
anew  and  make  another  selection  of  remedy."  It  is  in  this 
sense  that  we  have  understood  and  that  we  apply  Hahne- 
mann's  rule.  Not  pretending  that  we  do  not  often,  through 
errors  of  judgment,  infringe  it,  we  are  sure  that  whenever 
we  do  so,  misfortune  follows,  and  that  in  proportion  to  our 
faithfulness,  so  is  our  success. 

In  respect  of  the  repetition  of  doses,  as  well  as  the  form  of 
the  prescription,  we  have  no  difficulty  with  our  patients. 
Patients  are  like  soldiers;  they  believe  in  a  man  who  believes 
in  himself.  We  say  this  in  all  humility,  for,  in  a  matter  of 
science,  belief  in  one's  self  is  faith  in  the  laws  one  has  under- 
taken to  carry  out  in  practice.  And  if  the  physician  show 
confidence  in  his  methods,  his  patients  will  yield  themselves 
implicitly  to  his  guidance.  The  prejudice  in  favor  of  large 
and  many  doses  is  a  relic  of  past  ages,  when  the  practitioner 
was  paid,  not  for  his  skill  and  personal  services,  but  for  the 
medicines  he  furnished, — a  barbarous  usage,  which,  along 
with  slavery,  we  received  from  our  British  progenitors. 
Unlike  them,  we  have  discarded  the  former  but  not  the 
latter. 

4.  If  you  use  pellets,  do  you  consider  them  perfectly  re- 
liable? Assuredly,  or  else  we  would  not  use  them.  We 
medicate  them  ourselves. 

And,  how  many  constitute  a  dose?  If,  properly  medi- 
cated, one  is  as  good  as  one  hundred.  As  there  is  a  possi- 
bility that,  in  medicating  several  thousands  at  one  operation, 
a  pellet  here  and  there  may  fail  to  get  saturated,  we  usually 


264  REPLY  TO   A  LETTER 

give  about  four  to  six.     We  use  the  smallest  pellets  as  most 
easily  and  surely  medicated. 

5.  Do  you  alternate  the  high  potencies,  or  do  you  rely  upon 
the  single  remedy  ? 

Here  again  our  friend  confounds  a  principle  and  quantity. 
If  it  be  right  and  advantageous  to  alternate  the  low,  it  is 
right  and  advantageous  to  alternate  the  high  potencies. 
But,  in  fact,  we  do  not  alternate  at  all.  We  always  rely  on 
the  single  remedy  at  one  time.  Dr.  Drysdale  says  that 
everybody  alternates,  and,  therefore,  there  must  be  some 
necessity  for  the  practice.  But  his  illustrations  are  so  far 
fetched,  and  his  definition  of  alternation  is  so  contrary  to 
the  conceptions  which  all  other  homceopathicians,  from 
Hahnemann  down,  have  had  on  the  subject,  that,  notwith- 
standing our  respect  for  Dr.  Drysdale,  we  must  repeat,  in 
the  very  face  of  his  learned  paper,  that  we  do  not  alternate. 

Our  understanding  of  the  practice  of  alternation,  and  our 
objections  to  it  were  stated,  as  well  as  we  are  able  to  state 
them,  in  the  American  Homeopathic  Review,  June,  1863, 
vol.  iii.,  No.  12. x 

We  are  opposed  to  it  in  theory,  and  we  abjure  it  in  prac- 
tice. It  is  an  abominable  heresy.  As  a  shot-gun  maims 
where  the  rifle  would  kill,  so  alternation  may  change  and 
modify  and  maim  the  disease,  but  it  never  does  nor  can 
effect  the  clean,  direct  and  perfect  cure  that  a  single  remedy, 
exactly  homoeopathic,  will  accomplish.  As  a  relic  of  the 
polypharmacy  which  has  been  the  stumbling-block  of  the 
Old  School,  we  loathe  it.  As  a  refuge  of  the  careless  pre- 
scriber  and  slothful  student,  we  despise  it.  As  an  anomaly 
in  homoeopathic  practice,  a  fatal  obstacle  to  progress  in  the 
clinical  portion  of  our  Materia  Medica,  we  deplore  it. 

6.  Do  you  believe  that  the  high  potencies,  from  your  own 
experience  in  the  use  of  them,  and  from  what  you  have  beheld 
in  the  practice  of  others,  are  far  superior  in  all  respects  to  the 
low  preparations  as  remedial  agents  ? 

1  See  "Alternation  of  Remedies,"  in  this  book. 


ON  HIGH  POTENCIES.  265 

An  affirmative  answer  is  involved  in  the  statement  that 
we  use  the  high  in  preference  to  the  low  preparations. 
For  details  we  refer  again  to  the  article  which  prompted 
our  correspondent's  letter.  Personally  we  have  suffered, 
and  do  now  suffer,  from  chronic  organic  disease,  and  from 
occasional  very  violent  acute  attacks.  We  always  use  the 
high  potencies  in  these  cases,  preferring  them  to  the  low. 
We  use  them  in  our  family  and  among  our  friends.  We 
use  them  in  general  practice.  Many  of  our  friends  and 
patients,  non-professional  persons,  know  the  fact  and  freely 
say  that  they  and  their  children  are  more  speedily  cured  by 
the  high  than  by  the  low  potencies. 

N.  B.  The  imaginations  of  our  friends  aforesaid  are  not 
more  lively  than  those  of  the  average  of  other  people. 
Indeed,  they  are  plain,  matter-of-fact  persons,  possessing 
much  common  sense,  but,  for  the  most  part,  no  genius. 
They  prefer  high  potencies. 

And  now,  having  replied  in  detail  to  the  queries  of  our 
correspondent,  let  us  add  a  few  remarks  which  we  beg  him 
to  receive  in  good  part. 

To  change  the  aspect  of  a  case,  to  cause  the  original 
symptoms  to  be  supplanted  by  other  symptoms,  this  is  no 
more  a  cure  than  "a  strategic  change  of  base"  is  a  "victori- 
ous campaign."  Yet  this  may  be  effected  by  repeated  doses 
of  a  drug  in  a  low  potency,  whether  the  drug  be  strictly 
homoeopathic  to  the  case  or  not.  And  a  succession  of  such 
changes  and  supplantings  may  be  effected,  day  after  day, 
until  finally  the  patient  gets  well  or  nearly  so.  Meanwhile 
the  patient  may  be  amused  by  the  varieties  which  each  day 
brings  forth,  and  if  he  know  nothing  of  a  true  homoeopathic 
cure,  but  have  heretofore  had  only  the  heroic  treatment,  he 
may  fancy  he  has  been  doing  finely. 

Now,  in  this  way,  with  low  potencies,  a  practitioner  may 
do  quite  a  business  on  a  very  slender  capital  of  knowledge. 

Not  so  if  he  use  the  high  potencies.  With  these  no 
change  is  effected  in  the  case  unless  the  remedy  have  been 


266        REPLY  TO   A   LETTER   ON  HIGH   POTENCIES. 

strictly  homoeopathic  to  the  case.  They  are  like  the  rifle- 
ball — if  they  hit,  they  kill;  if  not,  there  is  no  record  of  the 
shot.  There  can  be  no  good  luck  from  scattering. 

Now  it  will  be  perceived  that  the  question  of  cures  with 
high  and  low  potencies  is  not  merely  a  question  of  potencies, 
and  our  friend's  trial  will  not  be  a  fair  one  unless  he  make 
sure  that  his  selection  of  the  remedy  in  each  case  in  which 
he  tries  the  high  potencies  is  strictly  homoeopathic.  If  he 
make  sure  of  this  and  be  correct  in  it,  then  let  him  go  on  in 
confidence  with  his  experiment.  We  bid  him  God-speed. 


THE  QUESTION  OF  THE  DOSE. 


In  a  report  to  the  Homoeopathic  Medical  Society  of  the 
state  of  New- York,  on  the  "Use  of  High  Potencies  in  the 
Treatment  of  the  Sick,"  published  in  this  Review,1  I  stated, 
"that  I  have  noted  only  one  case  in  which  a  high  potency 
acted  but  inefficiently,  while  a  lower  gave  prompt  and  com- 
plete relief;"  and,  again,  "that  a  general  law  for  the  a 
priori  selection  of  the  potency  suitable  for  a  concrete  case, 
if  such  a  law  be  possible,  is  yet  to  be  discovered;"  and, 
again,  "this  fact  that  a  low  potency  succeeded  where  a 
higher  had  failed,  together  with  similar  facts  reported  by 
other  practitioners,  must  have  a  bearing  upon  general  con- 
clusions." 

The  question  of  the  dose  is  manifestly  an  open  one.  Expe- 
rience must  be  accumulated  before  we  can  hope  to  discover 
a  law  for  our  guidance  on  the  subject.  Every  fact  bearing 
on  the  question  should  have  our  candid  and  careful  study. 

In  the  report  alluded  to,  a  portion  of  the  evidence  in  favor 
of  the  high  potencies  was  detailed.  The  following  cases 
present  evidence  on  the  other  side  and  deserve  particular 
attention.  They  are  published  by  Dr.  Arnold,  of  Heidel- 
berg, in  the  Homceopathische  Vierteljahrschrift?  together 
with  some  very  fair  and  ingenuous  remarks  by  Dr.  Arnold, 
who,  it  may  be  remarked,  is  in  the  habit  of  using  only  the 
lowest  potencies  or  massive  doses. 

Psoriasis  Guttata  cured  by  Arsenic. — The  power  of  the 
preparations  of  Arsenic  to  cure  psoriasis  is  so  well  known 
that  I  should  not  publish  this  case,  were  it  not  that  it  fur- 

1  North  American  Homoeopathic  *  Homceopathische  Vierteljahrschrift, 
Review,  vol.  4,  p.  303.  January,  1864. 


268  THE   QUESTION   OF  THE   DOSE. 

nishes,  in  addition,  a  striking  evidence  of  the  fact,  that  even 
in  chronic  diseases  we  are  often  obliged  to  give  strong  doses 
even  of  the  very  heroic  remedies  if  we  would  accomplish  a 
cure. 

A  lady,  eighteen  years  old,  whose  childhood  had  been 
healthy,  and  who  had  never  had  any  sickness  worth  naming, 
who  felt  perfectly  strong  and  well,  and  had  a  blooming 
appearance,  and  in  whom  no  predisposing  cause  for  any  skin 
disease  could  be  discovered,  observed  several  years  ago,  on 
certain  parts  of  the  body,  isolated,  red,  somewhat  elevated 
spots,  on  the  surface  of  which  small  scales  were  visible. 
Inasmuch,  however,  as  she  felt  well  and  the  spots  had  spared 
the  face  and  neck,  she  did  not  think  it  necessary  to  seek 
medical  advice.  Gradually  the  spots  became  more  numer- 
ous, their  dimensions  also  increased,  and  although  the  patient 
had  no  other  complaint,  she  was  yet  induced  to  seek  the 
advice  of  a  physician  on  account  of  the  itching,  which  was 
often  troublesome,  especially  at  night. 

Purgatives  and  the  so-called  blood-purifying  tea  (species 
lignorum)  had  no  result.  In  the  spring  of  1861  she  came  to 
me.  The  eruption  was  over  the  whole  skin  with  the  excep- 
tion of  the  face  and  hands ;  the  spots  were  large  and 
confluent.  I  gave  her  at  first  one  grain  daily  of  the  sixth 
decimal  trituration  of  Arsenic.  But  as  no  change  had 
occurred  in  fourteen  days,  I  changed  to  the  fourth  decimal 
trituration,  of  which  a  grain  was  taken  every  forenoon.  In 
fourteen  days  I  found  a  slight  improvement,  in  that  certain 
spots  seemed  to  be  less  red  and  did  not  itch  so  much  at 
night.  I  now  intermitted  the  use  of  Arsenic  for  three  weeks, 
and  after  this  period  found  again  the  old  evil  condition.  One 
grain  of  the  third  decimal  trituration  of  Arsenic,  which  was 
now  given  daily  for  fourteen  days,  wrought  a  more  striking 
improvement,  as  well  in  relation  to  the  development  and  size 
of  the  spots,  which  were  much  less,  as  also  in  respect  to  the 
itching  at  night  which  had  almost  altogether  ceased.  But 
inasmuch  as,  after  a  pause  of  fourteen  days,  this  improve- 


THE   QUESTION   OF  THE  DOSE.  269 

ment  had  again  partly  disappeared,  I  felt  myself  obliged  to 
resort  to  a  still  stronger  dose  of  the  remedy  in  order  not  to 
put  the  patience  of  my  client  to  too  severe  a  test.  She  now 
received,  once  every  day,  two  grains  of  the  second  decimal 
trituration — that  is,  one-fiftieth  of  a  grain  of  Arsenious  acid. 
The  action  of  this  dose  resulted,  after  two  weeks,  in  a  very 
striking  improvement,  which  moreover  maintained  itself 
during  a  suspension  of  the  remedy  for  the  next  two  weeks. 
I  therefore  allowed  the  patient  to  continue  the  remedy  for 
two  weeks  longer,  taking  daily  a  two  grain  dose  of  the 
second  decimal  dilution.  The  cure  was  complete  and  per- 
manent; for  a  half  year  afterward  I  had  an  opportunity  of 
seeing  the  lady,  and  was  assured  that  the  recovery  had  been 
lasting. 

On  the  subject  of  the  homoeopathic  relation  of  Arsenic  to 
psoriasis,  scarcely  any  physician  who  is  familiar  with  the 
effects  of  this  remedy  can  entertain  a  doubt.  I  must  confess, 
too,  that  I  have  often  seen  a  cure  result  from  the  use  of  the 
sixth,  but  still  more  from  the  fourth  decimal  trituration  of 
this  drug.  Even  in  the  case  just  related,  the  amelioration 
might  have  proceeded  to  an  enduring  cure  if  the  use  of  the 
fourth  trituration  had  been  continued  for  a  longer  time. 
But  inasmuch  as  the  patient  had  borne  the  Arsenic  very 
well,  and  not  a  single  symptom  of  its  pathogenetic  action 
had  been  apparent,  even  after  a  daily  dose  of  two  grains  of 
the  second  trituration,  there  was  no  reason  for  losing  time  in 
the  use  of  small  doses.  In  any  case,  this  is  a  new  evidence 
that  in  chronic  diseases  even  very  heroic  remedies  must 
sometimes  be  given  in  very  large  doses. 

Nasal  Polypus  cured  by  Calcarea. — A  lady,  aged  fifty-five, 
of  respectable  position  in  society,  pale,  of  delicate  constitu- 
tion, small  and  rachitic  from  childhood,  but  never  seriously 
ill,  perceived,  several  years  ago,  in  the  right  nostril  an 
impediment  to  respiration.  An  examination  by  a  physician 
readily  disclosed  the  presence  of  a  mucous  polypus.  Various 
remedies  were  administered  during  a  long  period  without 


2/0  THE   QUESTION   OF  THE   DOSE. 

perceptible  effect.  Neither  Mercurius  dulcis,  used  as  a  snuff, 
nor  Corrosive  sublimate  in  solution,  to  be  inhaled,  had  a 
noteworthy  or  enduring  effect.  The  patient  thought  the 
slight  changes  noticed  were  rather  to  be  ascribed  to  the 
weather,  and  especially  to  the  dryness  or  moisture  of  the 
atmosphere  than  to  the  remedies  used. 

Under  these  circumstances,  the  operation  being  proposed, 
I  was  asked  whether  a  cure  was  possible  without  operative 
procedures.  I  declared  that  a  cure  by  means  of  internal 
remedies  not  only  might  succeed,  but  that  it  would  have  a 
much  more  enduring  result  than  the  mechanical  removal  of 
the  growth  could  have ;  and  furthermore,  that  an  operation, 
in  case  it  should  prove  necessary  after  an  internal  treatment, 
would  be  more  certain  and  more  lasting  in  its  result  than 
one  without  the  previous  use  of  corresponding  remedies. 

Having  seen  from  Calcarea  carbonica  in  several  similar 
cases  a  very  striking  and  unmistakable  curative  action,  I 
prescribed  the  fourth  decimal  trituration  of  this  remedy  and 
ordered  at  first  one  grain  daily,  and  after  eight  days  two 
grains  daily  to  be  taken.  After  two  months,  the  patient 
appeared  and  reported  that  she  had  taken'  the  remedy  four 
weeks  and  then  intermitted  it  for  four  weeks,  and  that  no 
change  in  her  condition  was  observable.  And  I  could 
myself  perceive  neither  increase  nor  decrease  of  the  poly- 
pus excrescence.  This  determined  me  to  give  the  second 
decimal  trituration  of  Calcarea,  one  grain  daily.  After 
fourteen  days,  the  nostril  having  become  more  permeable, 
and  a  diminution  in  the  size  of  the  polypus  being  percepti- 
ble, although  very  trifling  in  degree,  I  allowed  a  pause  of 
four  weeks  in  the  use  of  the  remedy.  After  this  lapse  of 
time,  the  tumor  had  regained  its  former  size ;  the  lady  was 
more  than  ever  inclined  toward  the  operation. 

I  concluded  to  wait  upon  her  a  few  weeks  longer,  and 
gave  her  the  officinal  lime-water,  a  tea-spoonful  twice  daily  in 
milk.  Four  weeks  later  the  lady  came  again  to  me  ;  a  most 
careful  investigation  revealed  no  traces  of  the  polypus.  She 


THE   QUESTION  OF  THE  DOSE. 

informed  me  that  there  was  amelioration  after  the  very  first 
doses  of  lime-water,  and  that  after  a  fortnight  the  nose  had 
felt  entirely  free,  and  since  that  time  there  had  been  no 
aggravation. 

The  improvement  has  already  lasted  more  than  a  year 
without  any  further  administration  of  the  remedy.  Repeated 
examinations  have  failed  to  enable  me  to  discover  any  trace 
of  the  polypus. 


THE  BASIS  OF  TREATMENT.1 


Hahnemann,  throughout  his  works,  takes  every  opportu- 
nity to  urge  the  insufficiency  of  a  pathological  theory  of  the 
nature  of  a  disease  as  the  basis  of  the  treatment.  He  every- 
where urges  that  the  only  sure  indication  for  every  case  is  to 
be  found  in  the  totality  of  the  symptoms  which  the  case 
presents.  One  would  think  that  nothing  could  be  more  clear 
and  convincing  than  his  arguments  on  this  subject. 

His  opponents  declared  that  his  method  ignored  medical 
science,  left  no  scope  for  pathology  and  diagnosis,  and 
reduced  therapeutics  to  a  degrading  mechanical  comparison 
of  symptoms.  Very  many  homceopathists  have  so  far 
deviated  from  Hahnemann's  method  as  to  endeavor  to  blend 
with  the  use  of  his  doses  and  remedies,  an  application  of 
pathology  as  a  basis  of  treatment.  This  endeavor  can  never 
be  successful,  inasmuch  as  the  function  of  pathology  is  to 
furnish,  not  an  indication  for  medical  treatment,  but  simply 
a  means  of  elucidating  and  collating  the  symptoms.  The 
result  has  been  a  sad  falling  off  from  the  standard  of  success 
in  practice  which  was  established  by  Hahnemann  and  his 
pupils.  The  points  at  issue  are  illustrated  by  the  following 
case: 

Willie  M.,  four  years  old,  was  brought  to  me  December  3, 
1863.  He  had  been  healthy  since  February,  1863,  when  he 
is  reported  to  have  had  a  long  attack  of  gastric  fever,  from 
which  he  finally  recovered  with  the  affection  about  to  be 
described.  This  was  a  dyspnoea  and  wheezing,  distinctly 
perceptible  at  all  times  when  the  child  was  awake,  and 

*Read  before  the  Horn.  Med.  Society  of  Oneida  County,  N.  Y., 
June  2ist,  1864. 


THE  BASIS  OF  TREATMENT.  273 

which,  on  making  any  exertion,  were  very  much  aggravated, 
and  resulted  in  an  attack  of  convulsive  cough  with  difficult 
inhalation,  the  whole  paroxysm  resembling  precisely  what 
is  described  as  Millar's  asthma  or  Laryngismus  stridulus.  It 
was  remarked  that  the  child  seemed  to  be  free  from  dyspnoea 
when  sleeping  soundly,  but  at  no  other  time.  On  waking  in 
the  morning  he  had  always  a  hard  fit  of  coughing,  during 
which  he  sometimes  raised  a  little  tenacious  mucus.  His 
appetite  was  good,  though  somewhat  capricious.  He  was 
considerably  emaciated ;  his  spirits  were  good,  and  he  often 
attempted  to  join  in  the  sports  of  other  children,  but  was 
obliged  soon  to  desist,  because  of  the  dyspnoea  and  cough 
which  every  physical  exertion  caused  and  which  greatly 
fatigued  him.  On  percussion  and  auscultation  the  lungs 
were  found  resonant;  the  respiratory  murmur  was,  of  course, 
masked  by  the  loud  wheezing. 

The  child  had  been  taken,  in  September,  to  Professor  A. 
Clark,  of  New- York,  who,  after  careful  and  repeated  exami- 
nations, had  given  a  written  diagnosis — "Chronic  Laryn- 
gismus." He  gave  a  very  unfavorable  prognosis  and  the 
advice  to  avoid  all  medication,  save  only  a  dose  of  some 
antispasmodic  during  the  violent  attacks  of  dyspnoea.  This 
advice  had  not  been  followed.  The  child  had  been,  through- 
out his  illness,  under  what  I  regard  as  very  skillful  homce- 
opathic  treatment  I  had  once  seen  him  in  consultation,  but 
had  not  been  able  to  suggest  anything  that  proved  of  service 
to  him. 

When  now  placed  under  my  sole  care,  I  well  knew  that 
the  child  had  already  taken,  without  benefit,  every  remedy 
which  has  symptoms  at  all  resembling  Millar's  asthma  or 
any  spasmodic  affection  of  the  respiratory  organs.  And  it 
was  also  evident,  on  even  a  cursory  examination,  that  no  one 
of  these  remedies  was  clearly  indicated  by  the  symptoms  of 
the  case. 

I  therefore  resolved  to  follow,  as  implicitly  as  I  could,  the 
advice  given  by  Hahnemann  for  the  examination  of  the 
19 


274  THE  BASIS   OF  TREATMENT. 

patient  and  the  selection  of  the  remedy.  Dismissing  from 
my  mind,  then,  every  notion  concerning  the  seat  and  prob- 
able pathological  nature  of  the  disease,  I  examined  the 
patient  and  made  the  following  record  of  the  symptoms 
which  he  presented. 

1.  Child  emaciated,  flesh  soft,  skin  inclined  to  be  yellow 
(naturally  fair — a  blonde)  and  dry. 

2.  Appetite  very  good ;  always  calls  for  food  as  soon  as  a 
coughing  fit  begins  in  the  morning  or  forenoon. 

3.  The  right  hypochondrium  hard,  distended,  tender  to 
the  touch,  painful  on  exertion  and  when  he  coughs.     The 
right  shoulder  is  elevated  and  the  spinal  column  laterally 
curved ;  dullness  on  percussion  on  the  right  side,  extending 
three  fingers'  breadth  below  the  margin  of  the  ribs. 

4.  Distension  of  the  epigastrium  which  is  tympanitic  on 
percussion,  and  tender  to  the  touch. 

5.  Much  rumbling  of  flatus  in  the  abdomen. 

6.  Frequent  ineffectual  desire  for  stool ;  stool  scanty  and 
dry,  occurring  once  daily  or  once  in  two  days. 

7.  Cough  dry;  sometimes  in  the  morning  a  very  little 
tenacious  sputa ;  always  a  coughing  fit  in  the  morning  on 
waking ;   he   has  to  sit  up  to   cough ;    cough   excited  by 
eating  and  drinking,  by  rapid  motion,  by  exertion,  by  crying 
or"  talking.     The  cough  hurts  his  right  side. 

8.  Constant  wheezing  and  dyspnoea  aggravated  by  exer- 
tion and  by  lying  down,  relieved  during  sleep. 

The  tender  age  of  the  patient  rendered  it  impossible  to 
obtain  many  subjective  symptoms,  such  as  usually  facilitate 
the  individualization  of  cases,  and  the  determination  of  the 
appropriate  remedy. 

Before  proceeding  further  in  the  narration  of  the  case,  I 
desire  to  say  a  word  upon  its  pathology.  The  symptoms 
are  before  us  :  what  shall  our  diagnosis  be  ?  Is  the  case  one 
of  spasmodic  laryngeal  disease,  complicated  by  certain 
gastro-enteric  and  hepatic  affections?  Or,  is  it  a  chronic 
hepatitis,  complicated  by  laryngismus  ?  Which  affection  is 


THE  BASIS   OF  TREATMENT.  2/5 

primary,  and  which  secondary?  What  relation  do  the 
groups  of  symptoms  bear  to  each  other?  Professor  Clark 
seems  to  have  adopted  the  former  view,  regarding  the  gastro- 
hepatic  troubles  as  secondary,  if  indeed  he  paid  any  atten- 
tion whatever  to  this  complication.  The  homoeopathic 
physicians  who  preceded  me  probably  adopted  the  same 
view  and  based  their  treatment  upon  it.  Now  if  in  so 
doing  they  had  happened  to  take  a  correct  pathological 
view,  the  result  might  have  been  favorable ;  or  if  they  had 
adopted  and. acted  upon  the  second  hypothesis,  and  this  had 
chanced  to  be  the  correct  view,  the  result  might  have  been 
favorable. 

But  is  it  not  obvious  to  every  candid  mind,  that,  in  either 
case,  success  in  the  treatment  based  upon  a  pathological  con- 
sideration of  the  case  must  depend  on  the  correctness  of  the 
pathological  hypothesis — a  matter  in  which  certainty  can 
never  be  attained. 

On  the  other  hand,  if  we  throw  aside,  as  irrelevant,  the 
entire  series  of  questions  as  to  which  is  the  primary  disease 
and  which  the  secondary — which  the  original  malady  and 
which  the  complication — if  we  say  to  ourselves:  "Here  is 
a  sick  child ;  let  us  examine  and  record  those  points  in 
which  he  differs  from  a  healthy  child,"  we  get  the  series  of 
symptoms  above  recited,  which  are  facts,  indisputable, 
unmistakable,  the  result  of  pure  observation.  If  now,  with- 
out hypothesis  or  speculation,  we  seek  to  find  and  do  find  a 
remedy  which  presents  a  series  of  symptoms  corresponding 
closely  to  those  of  the  patient,  experience  justifies  us  in 
believing  that  we  shall  have  reached  the  utmost  possible 
certainty  of  correctly  selecting  the  remedy. 

Comparing  the  symptoms  with  the  Materia  Medica,  we 
perceive  at  once  that  the  remedies  whose  names  are  usually 
associated  with  Millar's  Asthma,  Laryngismus,  etc.,  viz.: 
Sambucus,  Spongia,  Cina,  Lachesis,  Hepar,  Stannum,  Chlo- 
rine, etc.,  etc.,  do  not  cover  the  case,  having  but  little 
correspondence  with  groups  i,  2,  3,  4,  $,  6. 


2/6  THE   BASIS   OF   TREATMENT. 

Nux  vomica,  on  the  other  hand,  covers  these  groups  very 
well,  as  will  be  seen  by  comparing  Materia  Medica.  In 
addition,  it  has  violent  paroxysms  of  cough  in  the  morning 
very  early  (676  and  677),  excited  by  motion  and  exertion 
(670,  671,  672),  producing  pain  in  the  epigastric  zone  (689), 
and  accompanied  by  a  desire  to  eat  (my  own  observation). 
It  has  also  a  well-marked  dyspnoea. 

The  correspondence  was  so  close  that  I  had  no  hesitation 
in  giving  Nux  vomica. 

Dec.  9,  four  powders  of  the  2OOth  were  given,  one  to  be 
taken  every  night,  and  the  patient  to  report  in  ten  days. 

Dec.  21,  the  report  was  brought  to  me,  that  the  child  had 
no  more  wheezing  nor  dyspnoea ;  had  been  free  from  cough 
for  five  days,  can  play  long  and  vigorously  without  incon- 
venience, is  regular  in  his  bowels,  complains  no  longer  of 
pain  or  tenderness  in  the  hypochondrium — in  fact  seems 
to  be  perfectly  well. 

He  deranged  the  digestion  by  eating  candy  at  Christmas, 
and  had  a  slight  return  of  pain  in  the  hypochondrium,  which 
a  dose  of  Sulphur  relieved.  He  has  ever  since  been  entirely 
free  from  dyspnoea  and  laryngeal  spasm,  and  is  in  the  enjoy- 
ment of  robust  and  perfect  health. 

If  such  a  mode  of  practice  as  this  be,  as  is  charged, 
unscientific — if  it  ignore  the  sciences  of  pathology  and  diag- 
nosis as  bases  of  treatment — thus  much  at  least  may  be  said 
in  its  favor,  that  it  far  surpasses  every  other  method  in  the 
facilities  it  affords  for  the  fulfillment  of  one  not  unimportant 
object  of  the  physician — the  cure  of  the  patient. 


DIAGNOSIS    IN    HOMOEOPATHIC    PRACTICE; 

WITH  COMPILATIONS  FROM  DR.  KASPAR'S  LECTURES. 

It  is  an  objection  often  urged  against  Homeopathy,  that, 
as  a  system  of  therapeutics,  it  dispenses  with  the  necessity 
for  diagnosis.  The  objection  is  unfounded.  For  all  pur- 
poses of  prognosis  and  hygienic  management,  we  have  as 
great  need  of  diagnosis  as  our  brethren  of  the  old  practice. 
And  so  we  have  in  prescribing.  We  profess  to  prescribe 
according  to  the  "  totality  of  the  symptoms."  But  by  this 
we  are  far  from  meaning  to  imply  {hat  each  symptom  is 
considered  and  prescribed  for,  independently  of  all  the  other 
symptoms.  On  the  contrary,  while  on  the  one  hand,  every 
symptom  must  be  taken  into  consideration  as  indispensable 
to  a  true  "  picture  of  the  disease,"  and  hence,  in  this  view, 
no  one  symptom  can  be  said  to  be  less  important  than 
another ;  yet,  on  the  other  hand,  the  symptoms  vary  among 
themselves  in  rank.  Some  are  primary  or  idiopathic,  others 
are  reflex  or  sympathetic.  The  latter  are  as  important  to  a 
"picture  of  the  disease"  as  the  former,  but  they  are  important 
not  simply  as  symptoms,  but  as  sympathetic  symptoms.  Now, 
to  form  a  diagnosis  is  to  distinguish  from  among  the  whole 
number  of  symptoms,  the  idiopathic  and  sympathetic  symp- 
toms, to  attribute  each  symptom,  whether  idiopathic  or 
sympathetic,  to  the  organ  or  tissue  which  is  in  reality  its 
seat,  and  to  form  a  just  notion  of  the  pathological  con- 
dition of  that  organ  or  tissue.  That  it  is  necessary  for  us  to 
make  such  a  diagnosis  before  prescribing,  follows  at  once 
from  the  rationale  of  a  homoeopathic  prescription. 

The  homoeopathic  practitioner  having  got  "a  picture" 
of  the  disease  he  is  about  to  treat,  *'.  e.,  having  got  the 


2/8  DIAGNOSIS   IN   HOMOEOPATHIC   PRACTICE. 

"  totality  of  the  symptoms,"  proceeds  to  compare  this 
picture  with  the  pathogeneses  of  various  drugs.  Now, 
these  pathogeneses  are  themselves  "  pictures  of  disease  ; " 
they  are  symptoms  of  drug-disease.  As  such,  they  are 
.divisible  into  idiopathic  and  sympathetic  symptoms ;  the 
organs,  or  tissues,  in  which  they  have  their  seat,  and  the 
pathological  conditions  of  these  organs,  may  be  various.  In 
seeking  a  drug  whose  symptoms  shall  correspond  most 
nearly  to  those  of  the  disease  to  be  treated,  it  is  evidently 
necessary  to  seek  a  drug,  the  idiopathic  symptoms  of  which 
shall  correspond  to  the  idiopathic  symptoms  of  the  disease, 
and  the  sympathetic  to  the  sympathetic  ;  a  drug,  too,  whose 
symptoms  of  either  variety  shall  have  the  same  seat  as  the 
analogous  symptoms  of  the  disease,  and  shall  result  from  a 
similar  pathological  condition.  But  we  cannot  select  this 
drug  without  having^  previously  formed  a  diagnosis,  not 
merely  of  the  disease  to  be  treated,  but  also  of  the  various 
drug-diseases  or  pathogeneses  that  constitute  our  Materia 
Medica.  This  necessity  may  be  illustrated  by  a  reference 
to  errors  into  which  a  neglect  of  it  leads  us.  Spontaneous 
vomiting  of  bile  by  a  child  may  be  an  idiopathic  symptom 
indicating  abdominal  derangement ;  or,  it  may  be  merely 
sympathetic  of  cerebral  disturbance.  Several  drugs  produce 
vomiting  of  bile  ;  some  directly  or  idiopathically,  by  affect- 
ing the  digestive  organs ;  others,  by  a  reflex  or  sympathetic 
action,  their  primary  action  being  on  the  nervous  centers. 
According  to  our  diagnosis  of  the  disease  in  the  child,  and 
of  the  drug-disease,  we  should  give  under  the  one  view,  Nux 
vomica,  Ipecacuanha,  or  their  analogues ;  or,  under  the 
other,  Belladonna.  Again,  depraved  appetite,  convulsive 
movements,  distorted  vision,  a  peculiar  aspect  of  distress, 
may  be  the  idiopathic  expression  of  disorder  in  the  nervous 
centers,  or  may  be  'sympathetic  with  irritation  produced  by 
entozoa.  In  the  one  case  we  should  select  a  remedy  which 
affects  the  nervous  centers  idiopathically,  as  Belladonna  or 
its  analogues ;  and  in  the  other  a  remedy  which  acts  idio- 


DIAGNOSIS  IN   HOMCEOPATHIC  PRACTICE.  2/9 

pathically  on  the  vegetative  sphere,  and  affects  the  nervous 
centers  sympathetically,  as  Cina.  Neglect  to  distinguish 
between  these  varieties  of  symptoms  has  led  compilers  of 
manuals  to  recommend  Cina  in  hydrocephalus. 

Moreover,  it  is  requisite  to  determine  the  seat  of  the 
symptoms,  both  in  the  disease  and  in  the  pathogenesis. 
Pain  and  tenderness  in  the  right  iliac  region,  with  local  heat 
and  fever,  may  have  their  seat  in  the  cellular  tissue,  in  the 
muscular  or  peritoneal  layers,  in  the  ccecum,  or  even,  at 
certain  times,  in  the  ovary.  So  might  similar  symptoms  in 
a  pathogenesis  arise  from  a  pathological  condition  of  these 
various  tissues.  Evidently  we  cannot  select  our  remedy 
with  certainty  of  its  adaptedness,  unless  we  make  a  diagnosis 
both  of  the  disease  and  of  the  pathogeneses  of  the  drugs. 

Again,  tenderness  in  the  coxofemoral  region,  pain  on 
moving  the  limb,  and  on  pressing  the  great  trochanter  in 
toward  the  acetabulum,  may  have  its  seat  in  the  tissues  of 
the  joint,  or  in  the  nerves  that  supply  that  region.  And  we 
have  drugs  that  affect  the  tissues  of  the  joint,  and  others  that 
affect  the  nerves  in  question.  We  must  select  the  former  if 
the  joint,  and  the  latter  if  the  nerves  be  affected ;  and  in 
order  to  make  the  selection  we  must  previously  make  the 
twofold  diagnosis  so  often  urged.  Neglect  of  this  has  led  to 
the  erroneous  recommendation  of  Colocynth  in  hip-joint 
disease.  A  twofold  diagnosis,  then,  is  a  necessary  pre- 
liminary to  a  properly  conducted  homoeopathic  prescription. 

The  diagnosis  of  the  disease  to  be  treated  is  to  be  made, 
of  course,  where  the  disease  is  encountered,  at  the  bedside. 
But  the  diagnosis  of  the  drug-diseases  constitutes  the  syste- 
matic study  of  the  Materia  Medica. 

Our  provings  are  a  mass  of  symptoms,  for  the  systematic 
study  of  which  some  feasible  method  has  been  long  a  desid- 
eratum. Their  study  and  arrangement  under  the  form  of 
a  diagnosis  furnish  a  method  well  calculated  to  fix  the 
characteristics  of  the  drug  in  the  memory,  and  at  the  same 
time,  as  we  have  shown,  practically  useful  to  the  prescriber. 


280  DIAGNOSIS   IN   HOMCEOPATHIC   PRACTICE. 

Dr.  Watzke  and  Dr.  Kaspar,  resident  physicians  in 
Wurmb's  Homoeopathic  Hospital,  in  Vienna,  have  arranged 
a  number  of  remedies  in  the  form  of  a  diagnosis,  the  expo- 
sition of  which  constituted  the  matter  of  lectures  on  Materia 
Medica,  delivered  by  Dr.  Kaspar  at  the  Hospital,  in  the 
summer  of  1851. l  The  substance  of  sixteen  lectures  by  Dr. 
Kaspar  follows,  from  which  the  scope  and  aim  of  the 
analysis  will  be  evident ;  and  it  may  not  be  amiss  to  sug- 
gest that  these  analyses  are  designed  rather  as  aids  in  the 
study  of  Materia  Medica  than  as  direct  guides  for  practice, 
and  that,  being  greatly  condensed,  they  require  diligent 
study  and  constant  comparison  with  the  Hahnemannian 
pathogeneses. 


NO.    I.        HEPAR   SULPHURIS   CALCAREUM. 

Hepar  has  many  close  relations  with  Mercurius.  The 
distinction  between  them  is,  in  fact,  rather  negative  than 
positive.  Almost  all  the  symptoms  of  Hepar  are  found 
under  Mercurius,  but  not  all  those  of  Mercurius  under 
Hepar. 

Hepar,  like  Mercurius,  develops  its  effects  in  the  vegeta- 
tive processes.  Yet,  whereas  Mercurius  increases  to  excess 
the  whole  secretive  activity,  and  thereby  produces  emacia- 
tion (i.  e.,  by  excessive  secretion,  salivation,  diarrhoea, 
diaphoresis),  the  same  character  belongs  to  Hepar  in  a  much 
less  degree.  Hence  Hepar  produces  no  putrid  collapse, 
makes  no  penetrating  impression  upon,  and  alteration  of, 
the  vital  processes  ;  hence,  too,  it  exerts  no  visible  reflex 
action  upon  the  nervous  life,  as  Mercurius.  While  the  reso- 
lutive,  alterative  action  of  Mercurius  extends  even  to  the 
formation  of  new  secreting  organs  (abscess,  secreting  pus), 
Hepar  possesses  no  such  power.  In  the  action  of  Hepar, 
appears,  in  a  slighter  degree,  the  tendency  to  abnormal 

1  These  lectures  the  author  attended. —  ED. 


NO.    I.      HEPAR  SULPHURIS   CALCAREUM.  28 1 

secretion,  and  the  resulting  symptoms  have,  for  the  most 
part,  quite  a  different  pathological  foundation  from  that  of 
analogous  symptoms  of  Mercurius. 

The  effects  of  Hepar  appear  most  distinctly  in  the 
lymphatic  system,  the  activity  of  which  it  excites  in  a  high 
degree  ;  and  hence  it  either,  on  the  one  hand,  increases  the 
absorptive  activity  of  the  lymphatic  system,  or  else,  on  the 
other,  causes  a  too  abundant  collection  of  lymph  in  the 
glands,  and,  in  consequence,  obstruction,  inflammation,  and 
suppuration  of  the  glands.  We  find,  therefore,  among  the 
symptoms  of  Hepar,  a  great  number  indicating  this  character, 
and  we  find  the  greatest  number  of  symptoms  in  those  parts 
of  the  body  in  which  the  lymphatic  vessels  are  most  abundant, 
neck,  shoulder,  bend  of  the  elbow,  dorsum  of  the  foot,  etc. 

On  the  increased  resorption,  on  the  other  hand,  depend 
a  number  of  other  symptoms  in  other  organs,  especially  in 
those  in  which  the  lymphatic  vascular  system  is  highly 
developed. 

Although  I  have  so  strongly  insisted  on  this,  as  the  sphere 
of  action  of  Hepar,  I  would  not  be  understood  to  deny  to  it 
any  farther  action.  The  excitation  of  organic  activity  can 
never  be  circumscribed  to  a  few  determinate  functions. 

If  the  resorptive  activity  of  the  lymphatic  be  increased,  so 
will  be  also  that  of  the  venous  system.  The  excretions  will 
be  altered  in  quantity  and  in  quality. 

The  action  of  Hepar  is  upon  the  periphery  directly. 
Hence  we  find  congestion  of  the  skin  and  mucous  mem- 
branes ;  and,  in  consequence,  redness,  heat,  swelling — in  a 
word,  an  inflammatory  condition  shown  by  prickings,  eleva- 
tions of  the  skin,  rhagades ;  a  slight  degree  of  suppuration 
manifesting  itself  in  rhagades,  pustules,  nodes,  tubercles, 
ulcers,  also  flashes  of  heat,  and  dull  redness  of  parts  rich  in 
blood — lips,  cheeks,  conjunctiva,  etc. 
•  Partly  in  this  way,  and  partly  also  by  the  fact  of  engorge- 
ment and  obstruction  of  the  lymphatic  glands,  we  may 
explain  the  symptoms  which  appear  in  the  skin. 


282  DIAGNOSIS  IN   HOMOEOPATHIC   PRACTICE. 

Mucous  Membranes.  These  are  similarly  excited.  Their 
secretion  is  not  greatly  increased.  Often,  indeed,  it  is 
diminished  ;  and  it  is  always  thickened.  The  watery  portion 
being  immediately  absorbed  again,  the  secretion  becomes 
viscous,  even  membranous. 

1.  In  the  Intestinal  Tract,  Heparmust  produce  diminution 
of  action ;  hence  anorexia,  nausea,  vomiting,  acid  eructations, 
alienated  taste,    development   of    gas,  etc.,  and,    above  all, 
enfeebled   peristaltic   action,   and   this,    again,    causes   pain 
(meteorismus)  and  difficult  evacuation  even  of  soft  faeces. 

Add  to  these  considerations,  the  irritation  of  the  mucous 
membrane  consequent  on  the  great  number  of  lymphatic 
vessels  in  it,  and  we  may  explain  the  several  sensations  and 
pains  in  the  alimentary  tract,  especially  the  frequent  tenes- 
mus  and  aggravation  after  every  stool.  The  stools  are 
green,  yellowish-brown,  often  mixed  with  blood. 

2.  In  the  Respiratory  Organs  we  find  a  similar  condition, 
various  sensations  indicating  thickening  of  the  secretions ; 
hence,  difficult  respiration,  laborious,  dry  cough.     This  con- 
dition, together  with  the  puffy  tumefaction  of  the  mucous 
membrane,  which  usually  accompanies  such  a  condition,  will 
explain  to  us  the  symptoms  which  we  find  especially  in  the 
larynx. 

3.  In  the   Urinary  Mucous  Membrane  appears  the  same 
state  of  chemosis.     Urine  is  scanty  and  dark,  with  abundant 
salts  so  that,  when  evacuated,  it  is  already  turbid,  or  else  it 
soon  becomes  so. 

4.  The  Salivary   Glands  are  excited  to  a  more  abundant 
secretion. 

The  action  of  Hepar  on  the  Sanguine  Vascular  System 
may  be  easily  determined ;  for  if  it  excites  one  portion  of 
this  system,  the  remaining  portions  must  of  necessity  be  also 
excited,  though  in  a  less  degree.  Hence,  febrile  symptoms 
are  not  wanting.  They  are  still  more  clearly  pronounced 
when  a  somewhat  violent  inflammatory  excitement  has  mani- 
fested itself,  producing  its  reflex  action  on  the  organism. 


NO.    I.      HEPAR   SULPHURIS   CALCAREUM.  283 

The  general  vascular  excitement,  however,  can  never  assume 
the  character  of  pure,  intense  synocha. 

The  relations  of  Hepar  to  the  Sexual  System  are  unim- 
portant. The  menses  appear  too  early,  and  are  too  copious. 

Sensations.  As  every  revulsion  of  the  vegetative  proc- 
esses provokes  various  sensations,  so  does  that  produced  by 
Hepar.  It  is  to  be  remarked,  that  pains?  strictly  speaking, 
are  seldom  excited  by  it.  The  more  frequent  sensations  are 
itching,  pricking,  rending,  and  feeling  as  if  beaten.  (In 
inflamed  parts,  however,  burning,  sticking,  and  tearing  pains 
are  experienced.)  Such  sensations  will  be  especially  felt  in 
parts  where  lymphatic  vessels  course  in  greatest  numbers, 
the  axilla,  bend  of  the  elbow,  etc. :  thus  we  have  heat,  redness, 
and  pain  from  the  fingers  to  the  shoulders ;  needle  stickings, 
itching  in  the  fingers,  swelling  in  the  fingers,  and  the  same 
condition  in  the  thigh,  ham,  dorsum  of  the  foot  and  the  toes. 

Characteristic  Symptoms. 

1.  Pains.      Various.     Especially    pressing    and    general 
sensations. 

2.  Aggravation  of  Condition.     At  night,  and  by  exposure 
to  cold. 

3.  Thickening  of  the  secretions,  swelling,    inflammation 
and  suppuration  of  the  glands. 

Indications  for  Administration.  Hepar  may  be  indi- 
cated— 

1.  In  diseases  of  acute,  sub-acute,  and  chronic  form. 

2.  In  diseases  occurring  in  lymphatico-phlegmatic  indi- 
viduals, with  white  delicate  skin,  blond  hair,  disposition  to 
glandular  swellings. 

3.  In   all  cases   of  glandular  affection,   as   well    for    the 
collective  chronic  process  as  for  the  individual  acute  exacer- 
bations ;   all  scrofulous  and  tuberculous  affections;    enlarge- 

1  The  Germans  distinguish  between  ing   in    the    shoulder.      Sensation   is 

Pain  (Schmerz)  and  Sensation  (Ge-  general,  as  to  extent,  and  indefinite, 

fiihl).     Pain  is  partial,  as  to  extent,  as  to  seat,  e.g.,  oppression,  lassitude, 

and  determinate,  as  to  seat,  e.g.,  stick-  itching. 


284  DIAGNOSIS   IN   HOMOEOPATHIC   PRACTICE. 

ment,  inflammation,  and  suppuration  of  all  lymphatic  glands, 
especially  those  of  the  neck;  a  similar  condition  of  the 
cellular  tissue.  Hence  it  is  indicated  in  mesenteric  diseases 
of  children;  in  frequently  recurring  angina ;  in  inflammation 
of  the  salivary,  cervical,  and  inguinal  glands ;  panaris ; 
inflammation  of  the  eyelids  ;  discharge  of  prostatic  fluid. 

4.  All  kinds  of  inflammation  which  pass  into  suppuration  • 
purulent  exudations    (pleuritis);    abscess    (for    maturation, 
Mercurius  is  preferable) ;  hip-joint  disease  (caries). 

5.  Inflammation  terminating  in  solid,  membranous  exuda- 
tions ;  acute  catarrh ;  laryngeal  croup  (after  use  of  Aconite) ; 
lymphangioitis,  as  well  external  as  uterine ;  phlegmasia  alba 
dolens;  hooping-cough,  after  the  stage  of  inflammation  (?). 

6.  Abscesses  and  analogous  formations. 

7.  The   Mercurial    Cachexy,       Calvities    after   Mercury; 
salivary  fistula. 

8.  Cutaneous  Affections.     Crusta  lactea ;  Tinea ;  Erysipelas 
(after  Belladonna)  in  scrofulous  individuals.     Generally  in 
scrofulous  skin-diseases. 


NO.    II.      CONIUM    MACULATUM. 

Conium  belongs  to  that  class  of  remedies  which  alter  the 
vegetative  vital  process  in  all  its  relations.  Among  the 
vegetative  functions,  that  of  resorption  suffers  the  first  and 
most  marked  alteration,  being  diminished  in  activity  or 
completely  arrested.  The  great  representative  of  this  func- 
tion is  the  lymphatic  system,  on  which,  therefore,  Conium 
exerts  its  primary  and  most  striking  action. 

Next  in  degree,  and  of  the  same  nature,  is  its  action  on 
the  venous  system.  The  diminution  of  the  vitality  of  this 
system  involves,  on  the  one  hand,  diminished  general 
absorption,  and  on  the  other,  retarded  circulation  of  the 
absorbed  fluids.  Hence,  collections  form  in  parenchymata 
and  cavities,  either  in  the  form  of  fluid  infiltration  or  exu- 


NO.    II.      CONIUM   MACULATUM.  285 

dation,  or  as  hard  tumors.  In  the  lymphatics  themselves 
depositions  occur,  which  sometimes  give  rise  to  tumors. 
Such  collections  are  hostile  to  the  organism ;  they  serve  as 
excitants  to  the  surrounding  tissues  ;  hence,  an  inflammatory 
condition  not  unfrequently  arises  in  these  formations,  which 
leads  to  their  destruction.  In  some  cases,  however,  the 
contrary  takes  place,  and  the  organ  attacked  becomes 
altered. 

On  these  general  pathological  momenta  depend  the 
following  Conium  symptoms. 

Skin.  Tuberculous  eruption,  passing  over  into  Furun- 
culi ;  Petechiae  ;  Erysipelatous  cutaneous  inflammations ; 
Gutta  Rosacea  ;  Ulcers ;  Gangrenous  ulcers. 

Glands.  Various  pains,  generally  sticking  or  cutting, 
especially  in  the  mamma  and  mesenteric  glands.  Indura- 
tion, suppuration,  and  alteration  of  the  same ;  hordeola ; 
swelling  of  the  tonsils.  Pains  in  the  liver.  Inflammation 
of  the  prepuce.  Pressing  in  prostate,  and  discharge  of 
prostatic  juice.  Orchitis ;  pain  and  swelling  of  testes. 
The  various  symptoms  in  the  breast  and  abdomen  indicate 
that  the  glands  are  attacked ;  but  the  fact  needs  anatomical 
demonstration.  The  general  disturbance  of  the  resorptive 
function  probably  depends  on  paralysis  of  the  ganglionic 
system,  in  consequence  of  which  all  the  vegetative  functions 
must  be  more  or  less  disturbed. 

Vascular  System.  The  vascular  system  loses  its  energy. 
The  circulation  becomes  irregular,  universally  retarded  and 
enfeebled.  Whatever  excitation  there  may  be  depends 
rather  upon  local  causes  than  upon  general  stimulus. 
Hence,  the  general  thermogenesis  will  be  rather  below  the 
normal  standard  ;  but  it  may  be  partially  increased.  Con- 
sequently, in  the  Conium  fever,  coldness  predominates ;  the 
pulse  is  slow  and  small.  (Still,  the  contrary  may  occur; 
the  pulse  may  be  quick  and  strong,  and  the  heat  partially 
increased.)  The  blood  in  the  venous  system,  therefore,  will 
be  propelled  slowly ;  hence,  this  system  will  be  gorged  ;  this 


286  DIAGNOSIS  IN  HOMCEOPATHIC   PRACTICE. 

will  be  especially  manifest  in  the  abdomen.  The  blood  does 
not  receive,  on  the  one  hand,  the  needed  reparation,  or,  on 
the  other,  the  necessary  elaboration  ;  it  consequently  tends 
to  fluidity  and  decomposition.  Accordingly,  cyanosis,  ecchy- 
mosis,  ulceration,  and  haemorrhage  may  easily  and  often  be 
provoked.  The  results  of  every  impediment  of  the  circu- 
lation are  manifested,  rather  in  the  periphery ;  hence,  sev- 
eral inflammatory  conditions  produced  by  Conium.  More 
frequently,  however,  the  same  cause  favors  the  origin  of 
infiltrations.  By  virtue  of  these  tendencies  we  have  inflam- 
mations of  the  eyes  and  eyelids,  hordeola,  inflammatory 
epistaxis,  haemorrhage  from  swollen  livid  gums,  irritable 
state  of  the  throat,  bleeding  ulcers,  haematuria,  and  inflam- 
matory symptoms  in  the  urinary  organs. 

From  what  has  been  said  of  the  general  primary  action  of 
Conium,  its  reflex  effect  on  the  individual  functions  of  the 
vegetative  sphere  necessarily  follow.  We  mention  the  con- 
ditions of  its  action  in  general  terms  and  in  specialties. 

The  vegetation  in  general  is  depressed ;  this  is  shown  by 
emaciation  and  change  of  color. 

The  secretions  are  in  general  diminished,  because  inter- 
stitial absorption  is  diminished  ;  for  secretion  must  necessarily 
proceed  pari  passu  with  absorption  ;  and  wherever  this  is  not 
the  case,  the  increase  of  secretion  over  absorption  must  be 
only  in  consequence  of  some  local  irritation,  e.  g.,  increase  of 
salivary,  lachrymal,  and  prostatic  secretions.  Hence,  vomiting 
is  rarely  produced  by  Conium.  And,  sinpe  Conium  furnishes 
scanty  secretions,  the  stool  is,  for  the  most  part,  retained 
and  scanty.  Urine  is  scanty  ;  the  mucous  membrane  of  the 
urino- genital  system  is,  for  the  most  part,  dry.  The  menses 
are  retained  or  retarded. 

As  specialty,  it  may  be  remarked  that  the  intestines  stand 
in  nearer  relation  to  Conium  than  the  stomach  does  (probably 
because  of  their  more  intimate  connection  with  the  mesenteric 
glands),  and  that  the  most  various  symptoms  are  produced 
in  them.  The  stool  is  generally  scanty,  with  flatulence  and 


NO.    II.      CONIUM   MACULATUM.  287 

pain  before  evacuation.  If  the  stools  are  abundant  and 
watery,  so  is  the  urine.  The  evacuation  of  urine  is  attended 
by  violent  pressing  and  by  burning.  The  sweat  is,  for 
the  most  part,  only  partial,  and  is  then  accompanied  by 
heat. 

Nervous  System.  The  action  of  Conium  on  the  nervous 
system  is  considerable,  yet  certainly  of  minor  importance 
and  often  secondary,  showing  itself  in  spasms  of  various  kinds; 
it  centers  in  the  sensorium,  where  depression  predominates. 

Sexual  System.  The  special  relation  of  Conium  to  the 
sexual  organs,  especially  the  female,  is  very  important.  Its 
action  is  especially  manifest  in  the  breast  and  uterus,  pro- 
ducing in  these  organs  swelling,  changes  arrested,  or  abnor- 
mal secretion. 

Condition.  The  Conium  symptoms  are  aggravated  at 
night  and  early  in  the  morning. 

ANALYSIS. 

1.  Alters  the  vegetative  functions  by  altering  or  modify- 
ing resorption ;  infiltrations  or  collections  result,  which  tend 
to  decomposition.     Increased  venosity,  and  finally  depraved 
nutrition  ;  effects  especially  evident  in  the  lymphatic  system 
and  in  all  glands,  and  among  these,  first,  the  mesenteric. 

2.  Glands.     In    closest    relation    with    female    sex    and 
mamma. 

3.  Nervous  System.     Secondary  Symptoms,  manifested  by 
spasms. 

4.  Secretions.     In  general  diminished. 

5.  Pains.     No  particular  character. 

6.  Aggravation.     Night  and  early  morning. 
Application.     Conium    corresponds    to  lymphatic,  blond, 

pale  individuals  ;  to  children,  especially  those  with  large, 
soft  abdomens,  and  tendency  to  glandular  enlargements  and 
cutaneous  eruptions ;  to  women,  especially  in  connection 
with  uterine  diseases  or  with  leucorrhcea  ;  to  women  in  the 
climacteric  period;  to  old  women  with  collections  in  the 


288  DIAGNOSIS   IN   HOMOEOPATHIC   PRACTICE. 

uterus ;  to  pregnant  women  ;  also  to  individuals  who  are 
easily  excited  ;  to  hypochondriacs. 

Diseases  in  general.  All  those  dyscrasias  whose  develop- 
ment begins  by  deposition  in  the  glandular  system.  Tuber- 
culosis and  scrofulosis,  especially  when  these  dyscrasias 
concentrate  in  the  mesenteric  glands  ;  when,  moreover,  they 
evince  rather  a  passive  character,  and  do  not  run  a  rapid 
course,  but  gradually  form  deposits,  and  thereby  give  rise 
to  partial  congestions;  in  the  first  periods  of  such  affections, 
so  long  as  there  is  no  especial  colliquation,  and  while  the 
secretions  are  in  general  diminished.  (If,  on  the  other  hand, 
they  show  an  active  character,  Hepar  is  indicated;  when 
colliquation  has  set  in,  Mercurius.} 

1.  Tuberculosis    Meseraica.      Tuberculosis     gland ularum 
maxillarum   colli.       Angina    in    tuberculoso    without  fever 
(Conium  alternated  with  Hepar). 

2.  Scrofulous    and     Tuberculous     Cutaneous     Affections, 
especially  lupus  sub-cutaneus  ;  tubercles  of  the  skin  ;  papules 
with  a  white  secretion. 

3.  Scrofulous    and    Sub-acute     Ophthalmia,    with    great 
photophobia    especially,    affection    and    suppuration    of  the 
meibomian  glands ;  formation  of  tubercles  on  the  eyelids ; 
conjunctivitis,  with  little  or  no  mucous  secretion;  keratitis, 
especially  when  nebulae  form ;  also  chronic  nebulae. 

4.  Scrofulous  Affection  of  the  Ears,  with  swelling  of  the 
parotids;  albuminous,  watery  otorrhoea. 

5.  Scrofulous  swelling  of  the  nose.     Ozaena. 

6.  Scrofulous   Spinal  Affection.     Pott's  curvature  ;   soft- 
ening   of    vertebral     column ;     scrofulous    coxalgia,   which 
develops  slowly  ;  scrofulous  and  tuberculous  caries. 

7.  In  Fibrous  Scirrhus,  in  so  far  at  least  as  at  the  begin- 
ning, it  consists  of  albuminous  infiltration,  Conium  may  be 
of  service  ;  but  generally  when  an  affection  of  this  kind  in 
the  mammary  or  axillary  gland  is  presented  to   our  notice, 
it  is  too  late  for  its  removal.      If,  however,  rational  symptoms 
or  hereditary  taint  give  reason   to  anticipate  or   suspect   the 


NO.    II.      CONIUM   MACULATUM.  289 

commencement  of  such  an  affection,  Conium  would  certainly 
be  among  the  most  useful  remedies,  yet  the  symptoms  of 
Conium  have  rather  the  character  of  those  of  infarctus  than 
of  developed  fibroides,  in  which  the  knife  alone  avails.1 

8.  Induration  in  general  of  mamma  and  uterus  (as  well 
after  reduction  of  inflammation  as  in  chronic  form),   with 
discharge  of  mucus.     All  indurations ;    not   so    markedly 
indicated,   however,   in   indurations  resulting  from   inflam- 
mation. 

9.  For  the  Carcinomatous  diathesis  Conium  can  do  noth- 
ing, even  in  the  beginning. 

10.  In  Atrophy  of  mamma  and  uterus,  Conium  may  be 
useful ;    the  conditions  to  which  Conium  corresponds  often 
coinciding  with  atrophy;    numerous  observations  show  its 
especial  applicability  to  affections  of  old  women. 

1 1.  Results  of  Contusions  ;  hence,  after  difficult  or  instru- 
mental labor. 

12.  Since  the  conditions  already  named  are  mostly  con- 
joined with  discharge,  Conium  may  be  considered  as  anti- 
leucorrhoeic.     Chlorosis,  amenorrhcea,  and  dysmenorrhoea, 
when  they  depend  on  the  same  cause,   indicate   Conium; 
yet  these  symptoms  may  be  independent,  and  may  still  coin- 
cide with  the  symptoms  of  Conium.     To  the  same  category 
belong  also  sterility,  milk-tumors,  and  affections  caused  by 
the  sudden  removal  of  the  child  from  the  breast. 

1  The    later   English    authors    are  tumor,  and  not  to  the  malignant  Can- 

disposed  to  confine  the  term  Scirrhus  cer  in  its  first  stage,   that  Coniura  is 

to  the  first  stage  of  Cancer,  before  ul-  applicable,  and  even  in  this,  to  benign 

ceration  takes  place.     Scirrhus,  then,  fibroides  only  in  the  formative  stage, 

is  always  a  malignant  affection.     The  During  the  year  1851,  two  patients  in 

Germans   apply   the    term,  however,  Dr.  Wurmb's  Hospital,  in  Vienna,  in 

indifferently  to  such  benign  or  malig-  whom    fibrous   tumor  of    the  uterus 

nant   tumors   as  from  their  physical  was  clearly  recognized,  were  treated 

character,  hardness,  merit  the  name.  with     Conium,      In  one,  the    tumor 

From  this  character,  the  benign  fibrous  disappeared;     in    the   other,    it    had 

tumor  (fibroides  of  Rokitansky)  of  the  greatly  diminished  in  size,  when  she 

uterus    or    mamma    is    often    called  refused  further  treatment. 

Scirrhus.      It    is   to    this    species    of  C.  D. 

20 


290  DIAGNOSIS    IN   HOMOEOPATHIC   PRACTICE. 

13.  Affections  of  the  Intestinal  canal;  seldom  when  these 
are  primary, — chiefly  when    they  are    combined  with,   or 
rather  are  consequent  upon,  a  general  condition  indicating 
Conium.      Vomiting   during    pregnancy;     diseases    of   the 
intestinal  canal  in  tuberculous  and  scrofulous  persons,  espe- 
cially scrofulous  children. 

14.  Dry,  nightly,  tickling  cough,  especially  in  scrofulous 
or  aged  persons ;  evening  dyspnoea ;  pertussis,  with  much 
vomiting ;  asthma  senile. 

15.  Feeble  condition  of  old  women  and  men;  hysteria; 
hypochondriasis  in  chaste  wedlock. 


NO.    III.      MERCURIUS. 

Mercurius    has    been   well    proved.     Its   symptoms   are 
chiefly  objective. 

1.  Its  only  primary  effects  are  on  the  vegetative  sphere, 
which  it  affects  in  the  highest  degree,  both  quantitively  and 
qualitatively.     It  alters  the  vegetation  so  deeply  and  thor- 
oughly, that  it  assimilates  itself,  as  it  were,  to  the  whole 
organism,  decomposes  and  separates  its  organic  constituents, 
and  becomes  itself  a  new  element  of  the  organism.     Hence 
arises  a  new  Mercurio-vital  process,  the  natural  vital  process 
having  given  place   to    the    operation    of   Mercurius.     All 
other   effects — viz.,    upon   the    nervous    system — are    sec- 
ondary. 

2.  In  the  vegetative  sphere,  Mercurius  attacks,  first  of  all, 
the    secretive    and    resorptive    processes.     (The    increased 
absorption  is  not  a  secondary  result  of  increased  secretion. 
Absorption,  as  well  as  secretion,   is  primarily  affected,   as 
is  shown  by  the  rapid  absorption  of  Mercurius  by  the  exter- 
nal skin.)     It  excites  both  of  these  processes  to  increased 
activity.     The  secretions  are  therefore  increased  in  quantity. 
They  are  altered  in  quality.     This  alteration  has  reference 
both  to  consistence  and  to  intimate  chemical  composition. 


NO.    III.      MERCURIUS. 


In  consistence,  they  become  thinner  and  more  fluid  ;  this 
effect  distinguishes  Mercurius  from  remedies  otherwise  anal- 
ogous, but  which  thicken  the  secretions.  (Hepar,  Conium.) 
As  to  chemical  composition,  they  become  acrid  and  exco- 
riating. This  twofold  alteration  depends  upon  the  peculiarity 
of  Mercurius,  already  stated  (i):  in  the  first  place,  this  plas- 
ticity of  the  secretions  is  diminished,  and  fluidation  instead 
of  coagulation  is  brought  about  ;  in  the  next,  in  the  room 
of  the  displaced  plastic  materials,  whose  decomposition  it 
effects,  Mercurius  insinuates  and  establishes  itself. 

3.  Mercurius  causes,  first,  a  condition  of  excitation  (even 
to  inflammation  and  suppuration).     This  is  to  be  explained, 
generally,  by  the  stimulating  action  of  Mercurius,  and  the 
reaction  of  the  organism.     Then  follows  a  torpid  collapse  of 
the    organic   forces,  —  weakness    even  to  exhaustion.     This 
results  from  the    commencing   decomposition   induced   by 
Mercurius. 

4.  Mercurius  penetrates  the  whole  organism.     No  portion 
escapes  its  action.     Before  all  other  parts,  however,  in  sus- 
ceptibility,  stand:    I.  All  the  membranes  and  the  glands 
of  the  lymphatic  system  ;  2.  The  parenchymatous  organs  ; 
and  3.  The  muscular  and  nervous  systems. 

EFFECTS  IN  GENERAL. 

I.  Vegetation.  The  vegetative  function  depends  upon 
the  equality  in  activity  '  of  the  secretive  and  absorptive 
processes.  If  one  or  both  of  these  be  abnormally  affected, 
nutrition  and  assimilation  (vegetation)  will  immediately 
sympathize.  Since  Mercurius  affects  these  processes  pri- 
marily, in  a  very  high  degree,  vegetation  must  be  deeply 
affected.  The  vegetative  process  is  retarded,  and  at  last 
entirely  arrested,  with  the  following  phenomena  : 

i.  As  to  Nutrition.  General  emaciation.  Laxity;  pale, 
earthy  hue  of  the  skin  and  mucous  membranes  ;  baldness. 
Sponginess  of  the  tissues,  especially  of  the  gums  ;  disposi- 
tion to  haemorrhage  ;  diseases  of  the  bones,  and,  as  a 


2Q2  DIAGNOSIS   IN   HOMOEOPATHIC   PRACTICE. 

natural  consequence,  great  weakness,  increased  by  every 
slight  effort;  great  sensibility  to  all  injurious  influences; 
violent  thirst,  double  vision. 

2.  Assimilation  (i.  e,,  with  reference  to  vitality  and  con- 
stitution of  the  blood)  is  most  deeply  affected.  On  the  one 
hand,  the  tone  of  the  vessels  is  depressed ;  and  on  the 
other,  the  blood  itself  loses  its  plastic  constituents,  becoming 
altered  in  composition.  Hence,  in  general,  the  pulse  is 
increased  in  frequency,  but  is  feeble  (it  may  be  also  slow 
and  soft).  In  the  beginning,  however,  congestion  and  even 
inflammation  occurs  in  individual  organs  ;  but  later,  only 
hyperaemia  and  stases  in  these  and  in  the  periphery.  Exu- 
dations often  occur,  partly  because  of  the  local  inflammation 
in  the  hyperaemic  parts,  and  partly  because  of  the  increased 
fluidity  of  the  blood.  Although,  in  consequence  of  the 
decomposition  of  the  blood,  the  venosity  threatens  to  pre- 
ponderate, this  result  is  nevertheless  obviated  by  the 
excessive  secretion,  and  anaemia  or  hydraemia  is  everywhere 
manifest;  or  if  venosity  become  manifest,  it  is  of  short 
duration,  showing  itself  in  ecchymosis. 

Secondary  Symptoms.  With  the  phenomena  above-men- 
tioned, the  whole  vital  energy  succumbs.  The  thermogenesis 
will  therefore  be  diminished.  Thus,  the  chilliness,  sensi- 
bility to  cold  air,  and  desire  for  the  warmest  possible 
temperature,  are  explicable.  This  is  the  general  condition ; 
there  may  be,  however,  temporary  and  partial  excitement 
of  the  vascular  system ;  and  hence  alternations  of  heat  and 
cold  occur,  which  appear  so  much  the  more  frequently,  as 
the  erethistic  condition  is  more  highly  developed. 

II.  Nervous  System.  The  effects  on  the  nervous  system 
spring  from  two  causes:  (i),  a  general  cause, — the  diminu- 
tion and  decomposition  of  the  fluids,  and  the  reduction  of 
the  functions  to  an  erethistic  or  even  a  torpid  condition ; 
and  (2),  a  special  cause, — the  action  of  Mercurius  upon  the 
membranes,  which  extends  to  the  neurilemma  and  the 
nervous  centers. 


NO.    III.      MERCURIUS.  293 

1.  The  nervous  power  is  diminished;  hence,  as  regards 
sensation,   a  feeling  of  great  depression,   as  well  as  actual 
prostration,  restlessness  and  general  indisposition;    and,  as 
regards  motion,   a   lack  of  power,   the  motions   becoming 
tremulous,    indirect,    and    scarcely   obedient   to    the   will : 
hence,    mercurial    trembling,    loss   of   speech,    dysphagia, 
cough,  etc. 

2.  By  virtue  of  the  special  cause,  the  neurilemma  being 
attacked,   true   neuralgia   occurs    (prosopalgia   mercurialis), 
especially  when  single  nerve-twigs  are  involved.     The  pain 
is  drawing  and  tearing,  attacks  generally  but  a  single  nerve  ; 
often  changes  its  location,  but  sometimes*  retains  its  seat  for 
months  ;    is  aggravated  by  hygrometric  changes,   and  by 
changes  of  temperature.     The  left  side  is  the  most  power- 
fully affected. 

3.  As  a  general  rule,  only  the  nerves  of  sensation  and 
motion  are  attacked,  the  vegetative  nerves  suffering  through 
the  local  conditions. 

4.  The   sensorium  is  generally   depressed    (save   during 
erethism)  ;  hence  giddiness,  irritability,  mental  disturbance, 
mania,  melancholy,  loss  of  memory,  imbecility. 

III.  Secretions  in  general.  The  secretions  of  every  kind 
are  altered  and  increased.  They  become  acrid,  and  the  quan- 
tity of  some  of  their  constituents  is  abnormally  increased. 

1.  Sweat.     Exceedingly   copious,    easily  provoked,  oily, 
sour,  giving  a  yellow  tinge  to  the  linen. 

2.  Of  Mucous  Membranes   in  general.      Acrid,   causing 
therefore  burning  in  the  anus  and    tenesmus,  tenesmus  of 
the  bladder,  and  burning,  before  and  after  micturition.    The 
salivary  secretion  is  characteristically  increased.     The  pan- 
creatic secretion  is  increased ;  secretion  of  bile  is  increased  ; 
hence  greenish-yellow  stools. 

3.  Genital  Organs.     Glandular  and  urethral  gonorrhoea  ; 
increased  discharge  of  semen.     Menses  increased  in  quantity. 
Leucorrhcea,  sometimes  mucous,  sometimes  purulent. 

4.  Respiratory  Organs.     The  peculiarities  of  the   secre- 


294  DIAGNOSIS   IN    HOMOEOPATHIC    PRACTICE. 

tions  induced  by  Mercurius  are  here  less  obvious.  The 
normal  secretion  seems  often  even  diminished.  Frequent 
haemorrhage. 

Abnormal  Secretions.     To  this  category  belong: 

(i.)  The  purulent  decomposition  of  inflamed  parts  gen- 
erally. 

(2.)  Formation  of  pustular  eruptions. 

(3.)  Ulcers  in  general,  as  combining  these  two  character- 
istics. For,  as  to  the  former,  the  suppuration  always  pro- 
ceeds from  an  inflammatory  process,  and  is  hence  preceded  by 
signs  of  inflammation, —  redness,  heat,  swelling, — especially 
when  occurring  in  the  glands  and  cellular  tissue  ;  hence 
swelling  of  the  gums,  fauces,  tonsils,  epiglottis,  parotid  and 
submaxillary  glands  and  inflammation  and  suppuration  of 
the  cervical,  inguinal,  meibomian  and  mammary  glands. 
Again,  as  to  the  latter,  the  eruptions  caused  by  Mercurius 
have  the  complete  character  of  inflammation,  with  a  ten- 
dency to  suppuration  or  to  puriform  collections.  (The 
irritative  character  of  Mercurius,  and  the  consequent  reaction 
of  the  organism,  together  with  the  tendency  of  Mercurius 
to  cause  fluidity,  induce  the  suppuration.)  The  pustule 
formation  is  often  incomplete ;  hence  erythema,  eczema, 
erysipelas,  impetigo,  rupia  (large  vesicles) ;  or,  in  mucous 
membranes,  aphthae,  herpes  praeputialis.  The  eruptions 
have  this  peculiarity,  that  on  the  spots  originally  occupied 
by  them,  sequelae  form — e.  g.,  scales. 

The  mercurial  ulcer  originates  in  inflammation,  removing 
the  epidermis,  and  producing  a  discharge  of  pus  and  sanies. 
The  ulcer  rapidly  increases  in  breadth  and  depth,  soon 
becomes  indolent  and  spongy,  and  finally  bleeds.  The 
circumference  is  red,  the  margins  puffed.  It  most  fre- 
quently occurs  in  mucous  membranes,  and  in  the  mouth 
and  on  the  genital  organs. 

5.  Serous  and  Fibrous  Tissues.  These  tissues  become 
irritated.  A  secretion  takes  place  in  the  capsules  of  joints 
and  sheaths  of  muscles,  fulfilling  the  conditions  of  rheu- 


NO.    III.      MERCURIUS.  295 

matism.  In  the  serous  sacs,  collections  of  water  form 
(mercurial  rheumatism),  and  also  of  pus.  Inflammation  of 
the  periosteum  occurs,  with  deposition  of  new  products, 
e.  g.,  gummata.  The  bones  become  dry  and  brittle,  through 
loss  of  fluidity. 

IV.  Mercurius  excites  the  lymphatic  glandular  system  in 
general,  even  to  inflammation  and  ulceration  of  the  glands 
(axillary,  cervical  inguinal,  etc.),  and  at  the  same  time 
primarily  stimulates  in  a  very  high  degree,  the  absorption 
in  the  lymphatic  vessels.  N.  B.  It  affects  especially  the 
salivary  glands,  increasing  the  secretion,  inducing  swelling, 
inflammation  and  suppuration. 

The  Liver.  Mercurius  induces  incomplete  reproduction; 
hence  the  fatty  diathesis.  It  is  indicated,  before  all  other 
remedies,  in  fatty  disease  of  the  liver,  resulting  from 
depressed  vegetation. 

For  the  Spleen,  Mercurius  has  little  affinity.  For  the 
Lungs,  more  than  for  the  spleen. 

ANALYSIS  IN  ANATOMICAL  ORDER. 

Head.     Various  sensations  and  pains.     Congestion. 

Eyes.  Irritation,  swelling  sensation  as  of  sand  in  the 
eye,  lachrymation,  conjunctival  congestion,  photophobia, 
ptosis,  oedema  of  cellular  tissue  and  conjunctiva,  loss  of 
brilliancy  in  cornea,  nebulae,  amblyopia,  amaurosis,  iritis. 

Ears.  Inflammation  with  pustules,  haemorrhage,  deafness, 
illusion  of  the  sense  ;  pains. 

Nose.  Peculiar  painfulness  of  nasal  bones.  Mercurius, 
above  all  remedies,  is  related  to  the  nose,  especially  to  the 
pharyngeal  portion  of  it.  Swelling  and  haemorrhage. 

Face.  Collapse,  paleness,  blue  rings  around  the  eyes. 
(Edema,  convulsive  jerkings. 

Teeth.  Swelling,  redness,  burning,  bleeding  of  gums; 
looseness  of  teeth,  aggravation  of  pain  by  cold  applications, 
and  at  night. 

Mouth  and  Pharynx.     At  first,  erythema;  at  the  same 


296  DIAGNOSIS   IN    HOMOEOPATHIC   PRACTICE. 

time  oedema,  vesicles,  pustules,  aphthae.  The  inflamed  spots 
are  very  sensitive  and  bleed  easily.  Swelling  and  dryness 
of  tongue,  discharge  of  saliva.  Difficulty  in  moving  the 
tongue,  even  to  paralysis. 

Throat,  (Esophagus.  Stiffness,  swelling  of  pharynx, 
pressing  pain,  and  excoriation.  Dysphagia.  The  tonsils 
are  first  affected,  then  the  gums. 

Digestive  Organs.  I.  Loss  of  appetite,  nausea,  bulimy, 
metallic  taste,  no  thirst,  save  a  desire  to  moisten  the  dry 
parts  affected.  2.  Digestion  disturbed.  Ructus,  vomituritis, 
collection  of  water  in  the  mouth  ;  nightly  nausea.  Mucous 
secretion  increased  and  changed ;  pancreatic  juice  altered. 
Stomach  pains.  3.  Abdomen.  Fullness,  oppression,  meteor- 
ism,  sensibility,  sticking,  cutting,  pinching  pains  in  liver.  4. 
Stools.  Frequent,  with  little  or  no  discharge  of  solid  or  soft 
faeces ;  pappy,  whitish-gray  or  green-yellow,  sometimes 
bloody,  acrid  and  excoriating;  tenesmus,  pinching  and 
burning  in  anus,  going  on  to  inflammation,  suppuration  and 
haemorrhage.  Dysentery. 

Mercurius  has  especial  affinity  for  the  two  ends  of  the 
digestive  canal.  The  stomach  and  upper  intestine  are  but 
slightly  affected ;  often  not  at  all. 

Genital  Organs.  The  mucous  membrane  is  the  part 
chiefly  affected. 

1.  Male.     Swelling;  formation  of  scales,  vesicles,  pustules, 
ulcers,    analogous   to   those   of  the    mouth    and   pharynx  ; 
discharges,  itching  and  burning ;  discharge  of  semen  without 
pleasure ;  gonorrhoea. 

2.  Female.     CEdema :  Leucorrhcea  purulent,  acrid.    Men- 
ses copious. 

Respiratory  Organs.  Expectoration  streaked  with  blood. 
Mucous  membrane  light-colored  ;  its  substance  little  affected. 
Coryza,  with  acrid,  purulent  discharge.  Trachea.  Dry 
irritation ;  cough,  with  bloody  sputa.  Lungs,  dyspnoea, 
asthma,  sticking  pains,  oppression. 

Back  and  Limbs.     In  these  parts  are  experienced  all  the 


NO.    III.      MERCURIUS.  297 

symptoms  relating  to  skin,  serous  and  fibrous  membranes 
and  bones,  e.g.,  itching,  crawling,  burning,  lassitude,  loss  of 
power — tearing,  sticking,  and  throbbing  pain,  cracking  of 
the  joints — cramps  and  trembling — oedema,  exostosis. 

Characteristics.  Aggravation  by  cold,  and  at  night; 
from  exposure  to  currents  of  air,  and  to  change  of  weather ; 
this  applies  to  all  the  symptoms.  Swelling  and  irritation 
of  the  parts  attacked,  suppuration,  ulceration,  pustular  erup- 
tions. Increased  and  acrid  secretions,  salivation,  diarrhoea, 
gonorrhoea.  Menses  too  copious.  Sweat;  trembling  and 
spasm,  especially  of  the  flexors.  Osseous  affections.  Es- 
pecial relation  to  those  mucous  surfaces  which  are  nearest 
the  external  skin. 

Application,  i .  Generally.  To  individuals  of  a  depressed 
vegetation,  of  a  tendency  to  mucous  and  bloody  discharge, 
to  suppuration  with  hydraemia,  to  affections  of  the  lymphatic 
and  glandular  systems.  To  children  in  the  period  of  denti- 
tion ;  to  youths  of  feeble  and  leucophlegmatic  temperament, 
but  not  torpid,  on  the  contrary,  rather  erethistic.  In  both 
acute  and  chronic  diseases;  in  the  former,  however,  not 
until  the  general  excitement  has  somewhat  abated,  and  the 
inflammatory  condition  has  become  localized.  In  simple 
inflammations  as  well  as  in  formation  of  deposits. 

2.  As  to  erases.  In  all  erases  characterized  by  slow 
depression  of  the  plastic  life,  by  increased  and  altered  secre- 
tions, and  still  more,  by  a  tendency  to  suppuration  or  to 
purulent  exudation.  All  erases  in  which  Mercurius  is  indi- 
cated are  characterized  by  erethism  and  never  by  torpor, 
hence,  Mercurius  does  not  stand  high  on  the  list  of  antiscor- 
butics, because  in  scorbutus  there  is  mere  collapse,  and  no 
tendency  to  suppuration.  Still  in  cases  of  scorbutus,  with 
manifest  excitement  combined  with  phlebitis,  it  is  often 
available.  In  other  cases,  Carbo  vegetabilis,  Arsenicum, 
China,  Arnica,  Lachesis,  are  preferable.  Mercurius  is  more 
strongly  indicated  in  the  tuberculous  and  scrofulous  erases 
when  the  parts  attacked  threaten  to  inflame  and  suppurate, 


298  DIAGNOSIS   IN   HOMOEOPATHIC   PRACTICE. 

and  where  erethism  is  present  and  ulceration  threatens.     As 
to  special  erases : 

1.  In  Tuberculosis.     In  the  second  stage,  with  tuberculous 
ulceration  and   copious  purulent  expectoration,  with  fever 
and  gradual  emaciation,  Mercurius  should  never'bo.  employed. 
It  is  indicated  only  in  an  erethistic  condition  of  the  lungs — 
hence  not  in  pneumonia,  rather  in  hectic  fever  in  consequence 
of  pyaemia.     In   tuberculous  affections    of  the  bones  with 
tendency  to  caries.     In  necrosis. 

2.  In  Scrofulosis,  with  ulceration  or  swelling  of  the  glands, 
otherwise  Calcarea  is  preferable.     Scrofulous  affections  of  the 
bones.     Scrofulous  ophthalmia.     In  rachitis,  as  distinct  from 
scrofula,  probably  not  so  appropriate  as  Calcarea. 

3.  In  Syphilis,  especially  when  the  mucous  membrane  and 
glands  are  affected — especially  when  ulcerated.     Mercurius 
has  less  affinity  for  the  eruptions  unless  they  be   pustular 
(Rupia).     Not  so  well   adapted   to    the    syphilitic   osseous 
affections. 

4.  In    Pytzmia,    from    absorption    of    purulent    matters. 
Except  Arsenic,  no  better  remedy  is  known  for  this  crasis. 
Also  in  erases  that  present  similar  symptoms  to  those  of 
pyaemia. 

5.  In   the    Inflammatory    crasis,    with    mild    fever    with 
tendency  to  localization,  and  inflammatory  exudations  in  the 
cellular  tissue  and  glands.     Pleuritis,  meningitis,  peritonitis. 
Inflammation    of   the    capsules    of  joints   and    sheaths    of 
muscles,  with  purulent,  plastic  exudations. 

6.  In  the   Typhoid  crasis,  Mercurius  is  scarcely  indicated 
unless  in  typhoid  parotitis.     But  in  puerperal  fever  it  is  a 
most  precious  remedy  against  both  the  local  affection  and  the 
general  condition.     In    metritis  puerperalis, — affections   of 
the  joints,  and  puerperal  deposits  (metastatic),  because  of  the 
general  tendency  to  pyaemia. 

7.  In  the  Rheumatic  crasis,  seldom  indicated,  rather  where 
the  periosteum  is  affected  with   aggravation  by  change  of 
weather. 


NO.    III.      MERCURIUS.  299 

8.  In  the  CEdematic  crasis,  contra-indicated  in  anasarca  or 
ascites. 

9.  Mercurius  is  indicated  in  Icterus,  with  irritation  of  the 
liver — febris  biliosa. 

10.  In  Exanthemata,  vesicular,  and  pustular  (seldom  the 
papular),  both  acute  and  chronic.     In  variola,  when  pyaemia 
is  established   after  the  repercussion  of  the   eruption.     In 
salivation ;  in  herpes  zoster  Mercurius  vivus  is  a  specific. 
In  benign  furunculus  (not  in  malignant),  impetigo,  miliaria, 
eczema,  crusta  lactea. 

INDICA  TIONS  IN  ANA  TOMICAL  ORDER. 

1.  Head.     Hydrocephalus  acutus;  abscesses  in  the  scalp; 
caries;  syphilis. 

2.  Ophthalmia  scrofulosa,  and  catarrhalis  with  purulent 
secretion  ;  inflamed  cellular  tissue. 

3.  Otitis  with  purulent  discharge. 

4.  Angina   with    tendency   to    suppuration.       Tonsillitis. 
Aphthae. 

5.  Swelling,  inflammation  and  suppuration  of  the  gums. 

6.  Glossitis;  inflammation  of  cellular  tissue  and  glands, 
with  irritation  of  all  surrounding  parts ;  suppuration,  ulcera- 
tion,  salivation,  toothache,  with  ulcers  from  caries,  stomacace 
(compare  Iodine). 

7.  Hepatitis,   acute  and  chronic.     Bilious  derangements. 

8.  Enteritis,  acute  and  chronic,  when  actual  pus  is  formed 
after  the  first  stage. 

9.  Diarrhoea  generally,  with  muco-purulent  stools,  green 
and  bloody,  tenesmus,  scanty  stools,  much  tormina,  burning 
in  rectum,  no  pains  in  the  abdomen. 

10.  Proctitis,  and  proctalgia,  with  discharge  of  pus  and 
blood. 

11.  Dysentery  in  high  grades,  with  purulent  secretions, 
tenesmus,  scanty  stool. 

12.  Inflammation  of  kidneys  (and  irritation  after  inflam- 
mation), with  irritation  and  purulent  urine. 


300  DIAGNOSIS   IN  HOMOEOPATHIC   PRACTICE. 

13.  Inflammation  of  the  bladder  and  urethra. 

14.  Gonorrhoea,      ulceration    of    the    genitals;     oedema 
praeputialis  (especially  in  children,  with  slight   erysipelas) ; 
orchitis;  leucorrhoea  excoriating. 

15.  Metritis,  especially  lymphangioitis,  leading  to  pyaemia. 

1 6.  Oophoritis     (after    Belladonna,    and    succeeded    by 
Platina).     Hydrops  ovarii.     (Graphites  ?) 

17.  Catarrh;  not  indicated  unless  there  be  purulent  dis- 
charge. 

1 8.  Myelitis. 

19.  Panaritis.     (Mercurius     yields    only    to    Hepar     in 
efficacy.) 

20.  Psoitis;    scrofulous  coxalgia    in   incipience.      When 
suppuration  already  exists,  Mercurius  does  not  remove  it. 
Phlegmasia  alba  dolens. 

21.  Arthritis.     White  swelling. 

22.  Trembling,  twitching  of  the  features,  as  a  secondary 
phenomenon.     Neuralgia. 


NO.  IV.      ACONITE. 

Aconite  is  the  general  representative  of  antiphlogistics. 

Effects  in  general.  I .  Vascular  System.  It  operates  power- 
fully as  a  direct  excitant  of  the  vessels,  and  produces,  there- 
fore, true  synocha. 

2.  Aconite   produces   no  crasis,   and   has,   therefore,   no 
tendency    to     product-formation.       Its     action     is    purely 
dynamic,  viz.:    the  pulse    is    much    accelerated,  hard   and 
strong;  thermogenesis  is    increased;    thirst    great;    general 
sensation  abnormal. 

3.  It  has  a  greater  action  on  the  more  vascular  organs  — 
hence  above  all,  on  the  lungs,  giving  rise  to  various  degrees 
of  excitement;  next  to  the  lungs  it  affects  the  periphery, 
and,  last  of  all,  the  intestines.     Hence  congestion  of  blood 
to  these  parts,  and  haemorrhages. 


NO.    IV.      ACONITE.  3<DI 

4.  It  has  no  especial  relations  to  the  fibrous  and  mucous 
tissues,  although  it  exerts    an  inflammatory  action    on  all 
organs  and   tissues  of    the  body.      (Bryonia  also  has  this 
specific  action,  although  it  excites  the  vascular  system  less 
intensely  than  Aconite.) 

5.  Its  action  on  the  Nervous  System  is  secondary,    i.  The 
sensorium  is  either  excited  in  consequence  of  the  vascular 
excitement, — hence  delirium, — or,   2.      It  is  depressed  by 
reason  of  the  vascular  congestion ;  hence  sopor. 

6.  Aconite  has  characteristic  morning  and  evening  exacer- 
bations ;  the  majority  of  the  pains  are  sticking ;  other  pains 
occur  according  to  the  nature  of  the  organ  attacked. 

General  Indications.  Aconite  is  generally  indicated,  I. 
In  all  inflammations  in  the  beginning,  against  the  vascular 
excitement  which  always  prevails,  before  the  disease  is  fully 
developed.  Its  action  is  brief,  and  does  not  interfere  with 
that  of  subsequent  prescriptions.  2.  As  an  alternating 
remedy  after  the  development  of  the  disease,  when  the 
vascular  excitement  continues. 

Special  Indications.  I.  (i.)  Inflammatory  Fever.  (2.)  In 
all  inflammations,  a.  While  the  vascular  excitement  is  great, 
and  before  any  product  has  yet  formed,  b.  When  the 
product  is  already  forming,  if  the  vascular  storm  has  not 
abated.  (3.)  Especially  in  inflammations  of  the  serous  and 
fibrous  tissues ;  Aconite  is  preferable  to  all  other  remedies 
in  these  cases — when  the  vascular  excitement  is  great,  and 
a  plastic  exudation  threatens  (for  less  intense  vascular 
excitement  and  a  threatened  serous  exudation,  Bryonia) ; 
hence  in  meningitis,  pleuritis,  peritonitis,  under  these  con- 
ditions. 

2.  In   Ophthalmia, — acute,    with   febrile    excitement, — a 
sovereign  remedy. 

3.  In  the   periods  of  dentition    and    menstruation  with 
vascular  excitement.      It   does  not  disturb   the    menstrual 
function. 

4.  Acute  Rheumatism. 

COL— V 


3O2  DIAGNOSIS   IN   HOMOEOPATHIC    PRACTICE. 

5.  Acute  Catarrh. 

6.  Tuberculosis  with  febrile  excitement. 

7.  Vascular  affections.     Arteritis,  pericarditis,  and  endo- 
carditis.    In  organic  heart  disease,  for  the  periodical  excite- 
ment.    (Aconite  is  preferable  to  Digitalis,  which  sometimes 
leaves  injurious  sequelae.) 

8.  Violent  dynamic  congestions,  depending  on  no  organic 
cause. 

NO.    V.      CALCAREA   CARBONICA. 

Calcarea  affects  exclusively  the  vegetative  system ;  all 
other  action  is  secondary.  The  secretive  and  resorptive 
functions  are  immediately  stimulated  to  increased  activity, 
and  a  condition  of  irritation  ensues.  All  organs  and  sys- 
tems are  affected,  the  nutrition  of  all  being  altered.  The 
lymphatic  system  is  affected  in  a  special  degree ;  and,  in 
the  mode  of  this  affection,  the  Calcarea  symptoms  resemble 
the  scrofulous  process  in  its  lower  grades.  Calcarea  is  a 
chronic  remedy,  because  it  alters  the  erases ;  also  a  sub- 
acute,  because  the  products  of  the  altered  erases  provoke  a 
state  of  irritation.  Its  action  is  not  stormy,  but  mild  and  slow. 

1.  Nervous  System.     Not  specifically  affected;    the   iso- 
lated spasms  that  occur  are  secondary.     Pains  corresponding 
to  the  nature  of  the  organs  attacked.     Sticking  pains,  and 
a  sensation  of  rigidity,  predominate. 

2.  Vegetation  in  General.     A  cachectic  habit  is  induced  ; 
decrease  of  temperature ;  puffiness  of  the  soft  parts ;  laxity 
and  general  debility,  with  increased  sensibility  to  external 
influences, — as  changes  of  weather. 

3.  Vascular  System.     Moderate  degree  of  fever;  chill  and 
heat  quickly  alternating ;  fugitive  heats  ;  chilliness  predom- 
inates.    Sweat  breaks  out  easily,   especially  in   the    palms 
and  soles  ;  evening  exacerbation.     Thus,  a  fever  resembling 
that  of  Tuberculosis.     The  composition  of  the  blood  is  not 
primarily  altered  ;  secondarily  it  is  altered. 


NO.    V.      CALCAREA   CARBONICA.  303 

4.  Lymphatic  System.     Excitement  and  irritation.     Re- 
sorption   is   deranged,   and    its    activity  is   increased ;    the 
glands  are  swollen,  irritated,  become  the  seat  of  a  deposit, 
and  even  pass  into  a  state  of  inflammation.      The  glands 
of  the  neck  and  mesentery  are  especially  attacked. 

5.  Skin.      Irritation,    evinced     by   erythema,    erysipelas, 
papules,  vesicles,  pustules,  bleeding  ulcers,  and  scaling  off  of 
the  epidermis,   especially  on  the  head  ;    the  skin  ulcerates 
easily,  especially  at  tender  points, —  e.  g.,  lips  and  margins 
of  eyelids,  the  inner  surface  of  the  arms,  and  the  anterior 
surface  of  the  thigh,  dorsum  of  the  foot,  and  outer  surface 
of  the  ear,  etc. 

6.  Mucous  Membrane  and  Glands.     Irritation.     Secretion 
rather  diminished  than  increased. 

ANALYSIS  IN  ANA  TOMICAL  ORDER. 

1.  Head.     No  especial  symptom  of  cerebral  disturbance. 
Frequent  congestion  in  consequence  of  the  general  irritation. 

2.  Eyes.     Irritation  and  rigidity  of  the  lids.     Conjunctiva 
reddened  ;  feeling  as  of  sand  in  the  eye  ;  photophobia  ;  the 
secretion  of  the  meibomian  glands  is  thick  and  glutinous. 
Lachrymal  secretion  increased. 

3.  Ears.     Increased    secretion    of    cerumen.       Purulent 
discharge ;  deafness. 

4.  Nose.     Ulceration   of  the    alae;    purulent,  foetid   dis- 
charge.    Dry  obstruction. 

5.  Mouth.    Gums  red  and  swollen.    Also  the  whole  mouth 
to  the  uvula.     Salivation.    Tonsils  and  palate  swollen.    Deg- 
lutition difficult 

6.  Intestinal  Tract.     In    stomach    and    abdominal  canal 
great  sensibility  to  pressure  ;  burning  and  pinching  pains. 
Loss  of  appetite.     Repugnance  especially  to  meat,  which 
passes  away  undigested.     Rancid,  sour  eructations.     Faeces 
long  retained ;  hence,  tormina.     Stools  solid  and  dry,  with 
straining.    Sometimes  also  diarrhoea  (secretion  being  abnor- 
mal   in  quality),  watery  and  pappy,  always  scanty.      The 


304  DIAGNOSIS   IN   HOMOEOPATHIC   PRACTICE. 

intestinal  secretion  being  abnormal,  induces  irritation ;  hence, 
spasm  of  stomach  and  intestine. 

7.  Liver.     Irritation,  especially  in  the  biliary  passages. 

8.  Urinary  Organs.     Pressing  and  sticking  in  the  kid- 
neys   and    bladder  ;    burning,    dysuria,    enuresis.       Urine 
diminished  in  quantity,    and    for   the    most  part   saturated 
with  saline  constituents,  and  hence  dark  or  turbid. 

9.  Genitals.     Congestion'  and    swelling.     As   to   sexual 
functions,  erethism  ;  and,  as  an  alternate  effect,  diminished 
instinct     Sweating  of  the  labia  and  scrotum  (in  gonorrhoea 
and  onanism,  compare  Sepia  and  Selenium,  Bcenninghausen). 
It  is  a  most  important  remedy  in    connection  with    early 
and  too  copious    menstruation ;    so    much   so,  that  it  acts 
favorably  only  when  these  conditions  are  present. 

10.  Respiratory  Organs.  Mucous  secretion  altered, — either 
increased  or  diminished.    Tenacious,  thick  mucus.     Dryness 
of  throat ;  dry  cough,  constriction  of  chest,  with  hoarseness 
and  roughness. 

11.  Muscles.     Stiffness;  pains  in  the  joints,  causing  diffi- 
culty of  motion.     (Calcarea  favors  the  secretion  of  chalky 
deposits  in  the  synovial  sac.) 

12.  Bone-pains  from  head  to  feet. 

Characteristics.  Calcarea  affects  primarily  only  the  vege- 
tative sphere ;  from  this  its  operation  extends  over  the 
whole  organism,  exciting  moderately,  producing  irritation, 
and  appearing  to  favor  a  deposit  of  the  earthy  salts.  The 
lymphatic  system  of  vessels  and  glands  is  first  and  most 
deeply  affected,  being  the  seat  of  irritation,  swelling,  depos- 
its, and  their  consequences.  The  skin  and  mucous  mem- 
branes are  next  affected ;  the  secretions  are  often  diminished, 
and  often  increased  (when  increased,  only  relatively),  and 
are  generally  acrid  and  sour.  The  whole  nutrition  suffers 
very  greatly.  Menstruation  is  too  early  and  too  copious. 
The  pains  are  various  ;  chiefly  a  feeling  of  stiffness,  with  or 
without  sticking  pains.  Aggravation  by  change  of  temper- 
ature, especially  by  cold,  and  at  night.  (Bcenninghausen 


NO.    V.      CALCAREA   CARBONICA.  305 

designates  many  important  symptoms,  which  are  aggravated 
in  the  morning,  in  contradistinction  to  corresponding  symp- 
toms of  Causticum,  which  have  evening  aggravation. —  C.  D.) 
Application.  To  youthful  persons  and  females ;  to  those 
who  are  badly  nourished,  pale,  with  affections  of  the  skin 
and  mucous  membranes ;  to  all,  in  short,  who  present  the 
scrofulous  diathesis,  or  one  like  it ;  especially  at  the  period 
of  development ;  dentition  and  puberty  (menses  too  copi- 
ous) ;  moreover,  for  children  generally.  The  symptoms  of 
Calcarea  present  a  striking  picture  of  erethistic  scrofula, 
for  which  diathesis  it  is  eminently  appropriate.  (For  the 
cancerous  diathesis,  Arsenic  ;  for  the  chlorotic,  Pulsatilla.) 
Tuberculosis  and  Rachitis,  with  excitement  and  irritation. 

1.  Children  who  do  not  walk  until  after  the  usual  age, 
who  manifest  great  irritability,  have  large,  distended  abdo- 
mens, and  scrofulous  inflammations  of  the  skin, —  i.  e.,  gen- 
erally little  vesicles  producing   crusts,  chiefly  on  the  head 
and  face,  lips,  nose,  and  eyes, — subjects  to  scrofulous  ophthal- 
mia, scrofulous  ozcena,  scrofulous  affections  of  the  ears, — 
especially  with  a  purulent  discharge.     In  atrophia  infantum, 
without  suppuration,  Calcarea  is  better  than  Arsenic.     In 
osteomalacia  ;  swelling  of  the  glands.    Indigestion,  with  acid- 
ity,  in  scrofulous   subjects.      Acid,  pappy  diarrhoea ;    also 
constipation.     Helminthiasis  in  a  scrofulous  diathesis.    What 
is  true  of  scrofula  in  general,  is  true  also  of  tuberculosis. 

2.  Adults  also ;  in  tuberculosis,  with  colliquative  sweats. 
Ophthalmia,  with    thick   blennorrhoea.      Ophthalmia  which 
has  left  behind  it  opacity  of  the  cornea.    Blennorrhoea  nasalis. 

3.  Rheumatism,  acute  or  chronic.     Tendency  to   vesical 
calculus. 

4.  Tonsillitis  frequently  recurring;  general  irritation   of 
tonsils. 

5.  Gastritis.     Chronic,   especially  with   acid  formations. 
Gastromalacia  chronica,  with  evacuation  of  undigested  faeces. 
Disposition  to  catarrh,  chronic  catarrh,  catarrh  of  bladder 
and  vagina. 

21 


306  DIAGNOSIS  IN   HOMOEOPATHIC   PRACTICE. 

NO.    VI.      BRYONIA   ALBA. 

Bryonia  is  in  every  respect  closely  allied  to  Aconite,  as 
well  in  its  general  relation  to  the  vascular  system  as  in  its 
special  affinities. 

1.  Vegetation.     It   operates   directly    on    the    vegetation, 
affecting  especially  the  secretive  process,  producing  a  high 
degree  of  irritation,  sometimes  even  inflammation.     First  of 
all,  however,  it  increases  the  activity  of  the  resorptive  appa- 
ratus ;     that   of  the    secretive   function    is    a   consequence. 
(Compare  Mercurius.)     Bryonia    induces    the   formation  of 
products,  viz. :  infiltration  into  the  cellular  tissue,  and  serous 
exudations  into  the  serous    sacs.     It   produces    no    plastic 
exudations    (as  Hepar   and  Mercurius    do).     The   blood  is 
affected,  as  in  the  milder  forms  of  typhus.     By  virtue  of  its 
action  on  the  resorptive  and  secretive  functions,  Bryonia  has 
especial    affinities   for   the   abdomen,  where    abound    those 
organs  and  tissues  on  which  it  especially  acts,  viz.,  serous, 
fibrous,  and  mucous  tissues. 

2.  Vascular  System.     The  vascular  system  is  excited  in  a 
less  degree  than  by  Aconite.     Its  action  is  partial,  i.  e.,  is 
exerted  upon  single  organs.     During  the  paroxysm  of  fever, 
the  chill  predominates,  occurring  often  in  the  midst  of  the 
heat      Thirst   is   very  intense    (because    of   the    increased 
resorption) ;  sweat  very  copious. 

3.  Nervous  System.  •  On  the  nervous  system   it   acts,    I. 
probably  directly,  attacking  the  serous  envelopes,  the  men- 
inges   and    neurilemma;     2.    mechanically,    the    excretions 
which  it  induces,  producing,  by  compression,  a  depressing 
effect. 

4.  Skin.     No  especial  relation.     Irritation,  oedema,  and 
vesicles,  characteristic.     No  pustules. 

5.  Eyes.     Irritation,  serous    secretion,   especially  attacks 
the  sero-fibrous  tissues   (keratitis,    sclerotitis,    iritis).      The 
secretions  are  at  first  watery ;  later,  they  are  purulent,  thick 
and  tenacious. 


NO.    VI.      BRYONIA   ALBA.  3O/ 

6.  Ears.     A  mild  form  of  periostitis — watery  discharge, 
sticking  pains,  illusions  and  dullness  of  hearing. 

7.  Face.     Generally  paleness;  frequently,  however,  fugi- 
tive heat,  swelling,  with  slight  redness. 

8.  Digestive  Apparatus.       Irritation.       Secretion    of  the 
mucous  membrane  is  at  first  thinned,  then  thickened,  and  then 
altogether  suppressed.     Burning  in  the  mouth  and  throat ; 
difficult  deglutition.     The  fibrous  coats  of  the  muscles  are 
especially  affected,  hence  pain  on  turning  the  head,  swallow- 
ing, etc.  (different  in  seat  from  pain  of  Belladonna).     QEdema 
of  the  gums,  and  of  the  whole  .cavity  of  the  mouth.     Perios- 
teum alveolorum  affected ;  excessive  sticking  pains  through 
the    entire  row  of  teeth,   accompanied   by  oedema  of  the 
gums,  even  to  the  roots  of  the  teeth.     Salivary  secretion 
increased  and  thin.     Stomach.     Digestion  disturbed,  in  con- 
sequence ructus,  vomituritio,  vomitus  post  pastum.     Intes- 
tine.    Similar  irritation ;    constipation  as  well  as  diarrhoea 
(serous) ;    rather,    however,    an    alternation    of    the    two ; 
pinching    and    burning    pains.       Peritoneum.       Irritation. 
Sticking  pain,  great  sensibility.     Hence,  symptoms  from  the 
liver,  kidneys,   bladder,  and  uterus   (their  peritoneal  coats 
being  affected).      The  secretion  of  the  liver  is  increased. 
The   stools   are    thin   and    green,    from    intermixed    bile; 
frequent   vomiting    of   bile.       The    kidneys    more    deeply 
affected,  secretion  diminished,  urine  clear.     For  the  sexual 
organs  it  has  no  affinity,  except  in  so  far  as  the  serous 
envelopes  of  the   organs  are  concerned.     CEdematous  and 
painful  swellings  of  the  testes. 

9.  Respiration.     Irritation.     Secretion,  for  the  most  part, 
increased,  thin  and  serous.     Dyspnoea.     Pleuritic  inflamma- 
tions, with  exudation. 

10.  Rheumatismus    Acutus.      Pain,    swelling,    increased 
temperature,  redness,  sensibility  to  changes  of  the  weather, 
inability  to  move  the  parts.     Inflammation  of   the  perios- 
teum, especially  of  the  head  and  face,  with  the  characteristic 
sticking  pains. 


308  DIAGNOSIS   IN   HOMOEOPATHIC   PRACTICE. 

The  symptoms  occur  chiefly  in  the  serous  and  fibrous  tis- 
sues. 

Application.  Bryonia  is  indicated  in  a  condition  between 
synocha  and  typhus,  resembling  the  former  as  respects  the 
vascular  system,  and  the  latter  as  respects  the  nervous  (com- 
pare Arnica).  It  is  suitable  for  nervous  and  bilious  tem- 
peraments, persons  of  dry  and  spare  habit,  dark  complexion, 
excitable  character,  and  predisposition  to  inflammation  of  the 
membranous  tissues ;  for  women  and  children  in  whom 
excitability  is  great,  but  energy  and  stability  of  reaction  only 
moderate,  who  are  inclined  to  lymphatic  exudations  and 
accumulations,  and  to  nervous  diseases,  and  at  the  same 
time,  in  an  equal  degree,  to  active  congestions. 

It  is  appropriate  in  all  varieties  of  rheumatism,  and  in  all 
conditions  in  which  catarrhal  and  rheumatic  characters  are 
combined. 

1.  Typhus.     The  efficacy  of  Bryonia  in  the  commence- 
ment of  typhus  is  attested  by  all  homoeopathic  writers ;  but, 
as  in  its  very  commencement  typhus  is  not  easily  recognized, 
the  claims  of  Bryonia  remain  sub-dubio.     In  typhus  versa- 
tilis,  however,  with  rheumatic  pains,  it  is  efficacious  in  all 
stages.     Also   in  complications  of  typhus,  with  meningitis 
or  pleuritis.     In  localized  typhus,  attacking  the  peritoneum 
or  pleura,  it  is  a  sovereign  remedy. 

2.  Intermittent  Fever.      Only  in  those  cases  in  which  the 
disease  acts  directly  upon  the  ganglionic  system,  in  which 
the  cold  predominates,  and  thirst  and  pain  in  the  limbs  are 
great,  with  accessory  symptoms,  e.  g.,  serous  diarrhoea  and 
sticking  pains. 

3.  Skin.     Urticaria.    Morbilli  with  oedema,  especially  with 
a  vesicular  eruption.     Miliaria  (copious  sweat).     Sweating  of 
the  feet,   not  offensive.     If  offensive,    Carbo-vegetabilis    is 
preferable. 

4.  Nervous  Affections,  of  various  kinds,  having  their  seat 
in  the  meninges  and  neurilemma.      Oppression,  dizziness, 
staggering,  etc. 


NO.   VI.      BRYONIA  ALBA.  309 

5.  Rheumatism.      Acute,    with    serous    exudations    and 
general  vascular  excitement. 

6.  Membranes.     Inflammation  of  serous  membranes,  with 
serous  exudations  containing  plastic  flocculi.     Irritation  of 
meninges  (in  actual  inflammation  Belladonna  is  better).   Con- 
junctivitis.    Hydrops  oculi  acutus.     CEdema  palpebrarum. 
Otitis.     Ozaena.     Swelling  of  the  face,  with  sticking  pain  or 
without   pain.      Toothache,   sticking   pain,    with   extensive 
swelling,  increased  by  cold,  alleviated  by  warmth.     Periton- 
itis, and  hence  hepatitis  and  enteritis  serosae. 

7.  Gastric  phenomena,  especially  serous  diarrhoea.     Also 
renowned  as  a  remedy  for  constipation.     (The  irritated  con- 
dition of  the  membranes  induces  diarrhoea,  and  probably,  at 
a  later  period,  dryness  of  the  membranes,  and  hence  con- 
stipation.) 

8.  Icterus,  depending  on  chagrin,  anger,  excessive  physical 
efforts,  and  a  sedentary  mode  of  life. 

9.  Mastitis,   in    nurses,  especially    when   the   mamma   is 
somewhat  cedematous  with  sticking  pains,  and  the  inflamma- 
tion  is   slight    (for    violent    inflammation,    with    hardness, 
redness,  and  pressing  pain,  Belladonna;  —  Phosphorus,  Bcen- 
ninghausen). 

10.  Respiratory  Organs.   Pleuritis.    Bronchitis  with  dimin- 
ished secretion,  much  irritation,  exciting  a  cough,  and  scanty 
serous  expectoration,  raised  with  difficulty.     In  pneumonia 
it  is  less  frequently  indicated ;  only  in  pleuro-pneumonia,  and 
in  pneumonia  with  great  oedema.     In  bilious  pneumonia  (of 
the  right  lower  lobe).     Bryonia  has  in  general  great  affinity 
to  the  biliary  apparatus. 

11.  General.    Pericarditis,  endocarditis,  hydrocele  (Rhodo- 
dendron).      CEdematous     glandular     swelling.       Sclereme. 
Anasarca,  especially  acute  oedema  pedum. 

In  phlegmone  colli  experience  has  shown  Bryonia  to  be  a 
most  valuable  remedy  (Wurmb). 


310  DIAGNOSIS   IN   HOMOEOPATHIC   PRACTICE. 

NO.    VII.      RHUS   TOXICODENDRON. 

GENERAL  EFFECTS. 

Rhus  acts  primarily  on  the  vegetative  system,  affecting 
especially  the  functions  of  resorption  and  secretion.  All 
other  symptoms  are  reflex  from  these  effects. 

1.  Its  primary  action  is  excitation  (irritation). 

2.  It   has   especial    relations   to    the    membranes ;     and 
especially    to    the   mucous  membranes    and    external   skin, 
producing  irritation  and  even  inflammation. 

SPECIAL  ACTION. 

1.  Vascular  System.    Irritation,  even  to  fever.    The  pulse 
is  hard,  full,  and  frequent,  and  the  heart  impulse  strong; 
but   the   peripheral   vascular   system    is    more    particularly 
affected,    and    sometimes    this  alone.     Hence    the   external 
heat  exceeds  the  internal;  both,  however,  are  abnormally 
increased;  thirst  is  very  great.     Vascular  torpor   is   only  a 
secondary    condition,    and    is,    hence,    no    indication    for 
Rhus. 

2.  Nervous   System.      Secondarily    affected.     In    case  of 
moderate  vascular  irritation,  the  nervous  system  is  excited ; 
in  case  of  very    great  vascular  irritation,  it  is    depressed. 
Hence,  in  the  former  case,  great  mental  excitement,  anxiety, 
irritation,  sleeplessness,  or  restless  sleep  with  anxious  dreams; 
and,  in  the  latter  case,  sinking  of  the  powers,  weakness  even 
to  syncope,  trembling,  and  convulsive  jerkings. 

3.  Cerebral  System.     Specifically  affected.     Symptoms  of 
incipient   typhus :     headache,    diminished    mental   activity, 
uncertainty  of  movement,  roaring  in  the  ears,  long  apparent 
pondering   before    answering  a    question.      These    cerebral 
symptoms  are   present  in  every   case  of  Rhus  intoxication, 
and  are  hence  characteristic.     Hence   the   applicability   of 
Rhus  in  typhus. 

4.  Nutrition.     Depressed,    but    not   in   a   very    marked 
degree. 


NO.    VII.      RHUS   TOXICODENDRON.  311 

5.  Secretions.  I.  In  the  higher  grades  of  excitement,  all 
the  secretions  are  diminished  in  quantity  and  thickened. 
2.  In  the  lower  grades  of  excitement,  they  are  increased  in 
quantity  and  thickened,  or  else  they  become  serous.  3.  The 
Rhus  irritation,  unless  it  proceed  to  inflammation,  is  always 
accompanied  by  serous  discharges,  in  the  form  of  evacua- 
tions or  of  cedema. 

TISSUES. 

1.  Skin.     Especially  affected.     Even  contact  of  the  leaves 
of  the   plant,  or  proximity  to  them,   produces  an  eruption, 
varying   in    intensity    from  the    slightest   erythema  to  the 
gravest  form  of  vesicular  erysipelas.     Vesicular  formations 
are  characteristic  of  Rhus. 

2.  Mucous  Membranes.    I.  Aphtha,  swelling  of  the  tongue; 
cedema    and    swelling   of  tonsils,    and    vesicular  angina  ; 
phimosis  and  paraphimosis,  vesicular  formations  on  the  whole 
penis,  scrotum,  and  perineum,  with  cedematus  swelling  of  the 
neighboring  parts.     This  Rhus  cedema  is  everywhere  hot 
2.  Dryness  of  the  mucous  membranes,  and,  in  consequence, 
difficult  deglutition,  tickling  in  the  larynx,  dry  tongue,  hoarse- 
ness, dry  and  painful  cough,  burning  in  the  chest,  burning 
pain  in  the  stomach,  nausea,  repugnance  to  stimulating  food, 
as  flesh,  wine,  etc.1 

Intestinal  Canal.  Tardy  action.  Tenesmus ;  painful 
evacuation  of  dry,  friable  faeces,  often  light-colored ;  also, 
but  less  frequently,  from  the  tendency  to  serous  depositions, 
thin  serous  stools.  (See  note.) 

Urine.  Diminished ;  evacuation  painful ;  tenesmus,  with 
burning;  emission  by  drops ;  also,  involuntary  evacuation. 
Urine  turbid  and  scanty,  with  copious  white  sediment ;  also, 
increased  in  quantity  and  pale.  (See  note.)  Region  of  the 
bladder,  sensitive. 

1  These  different  conditions  of  the      by  different   grades    of  intoxication. 
mucous    membrane    depend    on    the      Vide  supra,  Secretions,  I  and  2. 
different  degrees  of  irritation  induced  C.  ^. 


312  DIAGNOSIS   IN   HOMCEOPATHIC   PRACTICE. 

Sexual  System.     Excited  ;  a  condition  of  erethism. 

3.  Serous   Membranes.     Secretion    diminished;     dryness, 
cracking  in  the  joints ;  feeling  of  roughness  and  stiffness  ; 
sticking  pains. 

4.  Sero-fibrous  Tissues.     Secretion  diminished  ;  sensation 
of  stiffness  in  the  sheaths  of  the  muscles,  causing  pain  and 
difficulty  of  motion. 

5.  Osseous  System.     Periosteum  is  attacked;  boring  and 
deep  sticking  pains  in  the  malar  and  maxillary  bones. 

Characteristics.  Aggravation  during  repose  ;  amelioration 
by  motion  ;  action  often  confined  to  one  side,  more  frequently 
the  left  side. 

APPLICA  TION. 

General.  I.  To  acute  and  sub-acute  cases  ;  less  frequently 
to  chronic.  2.  In  affections  of  the  membranes,  especially 
if  accompanied  by  an  evident  dyscrasia,  and  attended  by 
nervous  phenomena.  3.  In  affections  resulting  from  expos- 
ure to  rain  while  perspiring.  (Boenninghausen.) 

Special.  I.  Vesicular  Cutaneous  Diseases  of  all  Varieties. 
Erythema  and  erysipelas  bullosum  ;  scarlatina  miliaris ; 
miliaria ;  carbuncle  ;  and,  generally,  all  cutaneous  eruptions 
that  tend  to  gangrene.  Herpes  acutus  ;  crusta  lactea ; 
hydrargyrosis ;  variola,  with  highly  developed  oedema  and 
great  cutaneous  irritation ;  acute  pemphigus  ;  cedema  after 
acute  eruptions,  with  redness,  heat  and  fever ;  acute  oedema 
per  se  (Morbus  Brightii  ?). 

II.  Sero-fibrous  Membranes.     Acute  and  sub-acute  rheu- 
matism  affecting  the  joints  and  muscles,  characterized  by 
considerable    swelling,    redness,    heat    of    the    joint,    pain 
diminished  by  motion,   increased  by   repose,  with   miliaria 
and  pustules  around  the  joint ;  rheumatism  of  the  fascia  lata. 

III.  Rheumatic  Odontalgia.      Tearing,  boring  pain  over 
the  whole  chin  ;  swelling,  redness  of  the  gums  ;  erysipelatous 
swelling  of  the  cheeks  and  region  of  the  lower  jaw,  even  to 
the  eyes  and  forehead. 


NO.   VII.      RHUS  TOXICODENDRON.  313 

IV.  Mucous  Membranes.     Acute  catarrhs  and  inflamma- 
tions ;    laryngitis,    bronchitis,     gastritis,    enteritis,    etc.,    of 
mild  degree,  attended  by  nervous  phenomena. 

1.  Conjunctivitis,    with    cedema,    vesicles   and   pustules ; 
great  pain,  dryness,  photophobia ;    gluing  together  of  the 
eyelids  ;  pain  on  opening  the  eyelids,  especially  in  scrofulous 
subjects. 

2.  Otitis  and  pharyngitis. 

3.  Inflammation  of  prepuce   and  scrotum,  with  vesicles 
and  cedema. 

4.  Mucous  diarrhoea,  with  great  tenesmus ;   first  stage  of 
dysentery,  scanty,  frequent  and  painful  stool. 

V.  Typhus  and  other  Maladies,  with  Nervous  Phenomena. 
In  the  lower  grade  of  typhus,  in  the  first  stage,  everything 
indicates  Rhus ;    predominant  excitement ;  constipation,  or 
frequent  serous,  greenish-yellow  stools,  especially  if  attended 
by  miliary  eruption. 

1.  Miliaria  puerperalis ;  purpura  haemorrhagia  febrilis. 

2.  Catarrhal  fever,  when  the  nervous  system  is  especially 
involved. 

3.  Puerperal  fever  in  the  lower  grades;  peritoneal  irrita- 
tion without   exudation,  rather  of  a  rheumatic  character ; 
exudation  scanty,  and  not  plastic. 

4.  Pleuritis  of  the  same  character  as  peritonitis,  nervous 
phenomena  accompanying. 

5.  Pneumonia;    difficult,  thick,  tenacious  expectoration, 
with  slow  and  tedious  resolution  (Pneumonia  notha). 

6.  Heart  diseases,  especially  of  the  pericardium,  attended 
by  nervous  phenomena. 

7.  Lumbago  ;  paralysis  in  lumbar  region.1 

8.  Intermittent  fever.     Nervous  symptoms  predominate. 
During   the    paroxysm    a    rheumatic   condition   comes  on. 
Thirst  and  heat  are  very  great     During  the  sweat,  miliaria 
make  their  appearance. 

1  Among  the  records  of  his  large  of  the  lumbar  muscles  in  cows,  after 
veterinary  experience,  Boenninghausen  calving,  cured  by  Rhus,  followed  by 
has  many  cases  noted  of  paralysis  Nux  vomica. —  C.  D. 


314  DIAGNOSIS   IN   HOMOEOPATHIC   PRACTICE. 

9.  All  diseases  bearing  a  resemblance  to  rheumatism, 
which,  however,  one  hesitates  whether  or  not  to  pronounce 
typhus. 


NO.    VIII.      COLCHICUM   AUTUMNALE. 

Colchicum  ranks,  in  almost  all  respects,  next  to  Bryonia. 
It  acts  especially  on  the  serous  and  fibrous  tissues.  Its 
characteristic  pains  are  sticking. 

1.  Differences.       I.    Bryonia  is  adapted   rather  to   acute 
diseases ;  Colchicum  to  sub-acute  and  chronic.     2.  Bryonia 
affects  the  vascular  system  more  deeply  than  Colchicum, 
exciting  fever.     3.  Bryonia  attacks  the  larger   serous  sur- 
faces; Colchicum  rather  the  smaller  ones  (articular  serous 
surfaces),  and  the  sheaths  of  the  muscles,  rather  the  fibrous 
and  fibro-serous,  than  the  purely  serous  tissues ;   hence  the 
periosteum  and  muscular  sheaths  are  especially  attacked. 

2.  Mucous  Membrane.     The  action  of  Colchicum  resem- 
bles  that   of  Bryonia ;    the    secretions    are    diminished   in 
quantity,  and  thickened  ;  but  Colchicum  produces  a  far  less 
degree  of  irritation  than  Bryonia  does ;  hence  its  applica- 
bility in  chronic  catarrh,  with  a  moderately  copious  tenacious 
mucous  secretion  (catarrh  of  old  people). 

3.  Nervous  System.     No  especial  primary  action. 

4.  Adaptation.      Colchicum    corresponds   to    the   venous 
constitution,    the    phlegmatic,     melancholic    temperament; 
Bryonia  rather  to  the  nervous,  erethistic  temperament. 

The  pains  of  Colchicum,  like  those  of  Bryonia,  are  aggra- 
vated by  touch  and  by  motion ;  those  of  Colchicum,  how- 
ever, are  worse  in  the  evening  and  during  the  night ;  while, 
generally,  the  symptoms  of  Bryonia  are  aggravated  in  the 
'morning  on  awaking. 

Colchicum,  like  Bryonia,  produces  tearing,  sticking  pains  ; 
but  those  of  Colchicum  appear  as  tearing  or  sticking  jerkings 
through  the  periosteum,  while  the  pains  of  Bryonia  are 


NO.    IX.      LEDUM    PALUSTRE.  315 

accompanied  by  the  general,  feeling,  as  if  beaten  (zerschla- 
genheitschmerz)  throughout  the  muscular  system. 

Colchicum,  then,  is  more  suitable  when  the  excitation  is 
slight, — when  the  disease  inclines  rather  to  a  torpid  char- 
acter, therefore  to  diseases  of  torpid,  phlegmatic  individuals. 

5.  Chief  Sphere  of  Action.  Rheumatism  (sub-acute  and 
chronic,  but  not  of  very  ancient  date),  chronic  gout,  with 
thickened  secretions,  especially  if  characterized  not  so  much 
by  pain  as  by  impediments  to  the  free  motion  of  the  parts 
(semi-paralysis,  quasi-paralysis).  In  the  latter  stages  of 
acute  rheumatism  Colchicum  is  often  indicated.  (Kaspar 
appears  to  find  frequently  appropriate  in  acute  rheumatism, 
1st,  Aconite;  2d,  Bryonia;  3d,  Colchicum.) 

In  dropsy,  conjoined  with  a  general  torpid  condition,  with 
little  or  no  irritation, — dropsy  after  exanthematous  diseases, 
— also,  but  less  frequently,  in  dropsical  affections  of  the 
synovial  sacs,  and  of  the  thoracic  cavities, —  Colchicum  is 
indicated. 

In  diarrhoea,  with  plastic  excretion  and  rheumatic  com- 
plication, characterized  by  great  flatulence, —  in  a  low  grade 
of  autumnal  dysentery,  or  rather  in  sanguineous  diarrhoea 
than  in  real  dysentery, —  Colchicum  is  appropriate. 

In  hydrops  oculi,  diseases  of  the  sclerotica  and  cornea, 
and  especially  opacity  of  the  cornea, — and  among  affections 
of  the  chest,  in  chronic  catarrh,  with  scanty  plastic  secre- 
tion, and  great  sensibility  to  changes  of  temperature,  espe- 
cially to  cold  air, — Colchicum  shows  itself  efficacious. 


NO.  IX.      LEDUM   PALUSTRE. 

Ledum  ranks  next  to  Colchicum  in  its  action  on  the  serous, 
fibrous,  and  mucous  membranes.  Its  action  is  more  power- 
ful than  that  of  Colchicum,  producing  not  only  irritation 
and  an  increased  thickened  secretion,  but  also  a  deposit  of 
solid,  earthy  masses. 


316  DIAGNOSIS   IN    HOMCEOPATHIC    PRACTICE. 

Vascular  System.  In  their  relations  to  this  system  are 
found  the  true  distinctions  between  Bryonia,  Colchicum,  and 
Ledum.  Ledum  affects  the  blood  distinctly,  producing  a 
definite  crasis,  viz. :  a  tendency  to  exudation  of  blood  ;  hence 
we  find  it  producing  haemorrhages  (which  are  not  induced  by 
Bryonia  and  Colchicum).  The  blood  has  a  special  tendency 
to  the  periphery.  Moreover,  Ledum  has  far  greater  rela- 
tions to  the  periosteum  and  mucous  membrane  than  either 
Colchicum  or  Bryonia  (of  these  two,  Colchicum  has  the 
greater  affinity  for  mucous  membranes  and  periosteum).  The 
pains  of  Ledum  are,  to  a  greater  extent,  sticking  and  tear- 
ing, sticking  as  if  caused  by  needles,  as  well  in  internal  as 
in  superficial  parts. 

A  characteristic  of  Ledum  is  a  deficiency  of  vital  heat, 
inducing  a  predominant  coldness  and  ehilliness.  As  in  the  case 
with  Bryonia  and  Colchicum,  the  sticking  and  tearing  pains, 
and  also  the  symptoms  that  occur  at  night,  are  aggravated  by 
motion  and  by  warmth.  Like  Bryonia,  Ledum  produces  a 
hot  swelling,  but  it  has  an  especial  affinity  for  the  hip  and 
shoulder. 

Application.  \.  In  chronic  rheumatism  Ledum  is  espe- 
cially indicated  when  the  secretion  is  scanty  and  thick,  and  is 
no  longer  absorbed,  but  concretions  begin  to  form,  residua 
in  periosteal  and  cartilaginous  envelopes,  pain  greatly 
increased  by  motion.  Ledum  has  a  special  affinity  for  the 
regions  of  the  hip  and  shoulder.  The  affection  must  not  be 
entirely  chronic ;  in  such  a  case  the  mineral,  remedies  are 
rather  indicated,  Calcarea,  Mercurius,  Iodine,  etc.  To  be* 
consulted  in  coxalgia,  lumbago,  arthrocace.  In  affections 
of  the  bones,  especially  in  the  formation  of  nodes. 

2.  Chronic  Cutaneous  Affections.     Transformations  of  the 
epidermis.     Ecchymoses   (rather  in  chronic   cases,  such   as 
chronic  morbus  maculosus).     Bleeding  ulcers  on  the  fore- 
head.    Tuberculous  eruptions  in  drunkards. 

3.  Intermittent  Fever.     When  the  cold  stage  is  of  long 
duration,  with  violent   thirst.      Neglected  typhus,  with   I, 


NO.    X.      SEPIA.  317 

important  anaemia,  or  2,  visible  alteration  of  the  blood 
crasis  (inducing,  for  instance,  ecchymosis),  or  3,  affections  of 
the  mucous  membranes  especially  (nasal  haemorrhage  or 
bloody  expectoration  without  irritation). 

4.  Headache.     Especially  in  the  sequelae  of  syphilis,  and 
in  mercurial  poisoning. 

5.  Ophthalmia    Chronica.      A  renowned  remedy,    espe- 
cially in  affections  of  the  mucous  membranes,  with  copious 
secretion  from  the   meibomian  glands  and  opacity  of  the 
cornea. 

6.  Dropsy,  viz.,  Ascites.  Ledum,  like  Colchicum,  has  a  great 
affinity  for  the  abdominal  organs,  probably  because  of  their 
great  venosity. 

7.  Chronic  Pulmonary  Catarrh.     Even  in  pneumonia,  if 
the  symptoms  correspond,  especially  if  the  cough  is  accom- 
panied by  bloody  expectoration,  and  threatens  to  become 
chronic.     Tuberculosis  with  haemoptysis. 

8.  Tubercular  disease  of  the  bones.     Ulcers  of  skin  and 
gangrenous  ulcers.     (Hartmann.) 

9.  Gout.     According  to  Rau's  experience,  one  of  the  chief 
remedies,  even  for  maladies  complicated  with  gout. 


NO.  X.     SEPIA. 

GENERAL  EFFECTS. 

Sepia   is    essentially   a    remedy  affecting  the    vegetative 
sphere.      Its  other  effects  are  only  secondary. 

1.  It  has  a  transforming  action,  altering  the  erases.     Its 
action  is  slow,  but  deep  and  prolonged. 

2.  It  diminishes  the  reproductive  energy  of  the  vegetable 
sphere.     This  is  made  manifest — 

a.  Through  the  sluggish  performance  of  the  functions. 

b.  Through  the  deficient  general  nutrition. 

3.  Pains   and    isolated    symptoms   are   but   feebly   pro- 
nounced. 


3l8  DIAGNOSIS   IN    HOMCEOPATHIC   PRACTICE. 

4.  It  has  special  relations  to  the  portal  system,  and  to  the 
female  sexual  system. 

SPECIAL  EFFECTS. 

A.  Primary.   I.  Digestion  is  impaired,  acidity  predominat- 
ing;   sour  and  foul  eructations;   tormina  and  meteorismus ; 
chilliness  after  meals ;  neither  copious  diarrhoea  nor  obstinate 
constipation ;    frequent  tenesmus.      Haemorrhoidal   tumors  ; 
excoriation  between  the   nates  (corresponding  to  the  acrid 
character  of  the  discharge). 

2.  On  the  Portal  System  and  the  Liver,     a.  Functions  of 
the  Liver.      In  degree  these  are  not  greatly  disturbed.     In 
kind  the  bile  is  altered  ;  it  acquires  a  sour  or  foul  character 
(hence  vomiting  and  diarrhoea)  with  too  little  alkali. 

b.  It  induces  also  a  change  of  texture  in  the  liver,  as  is 
manifested  by  the  disturbed  state  of  the  circulation  (numer- 
ous stases). 

c.  The  complexion  is  altered.     The  skin  becomes  yellow 
and  earthy- colored — like  the  wax  of  old  church  candles. 
Puffiness  of  the  soft  parts ;  there  is  no  emaciation ;  this  appears 
later — first,  an  increase  of  the  fatty  tissue,  then  laxity  and 
flaccidity,  lastly,  emaciation.     Also,  irritations  of  the  skin, 
showing  itself  in  red  spots  with  yellow  areolae. 

d.  Mental  depression ;  sadness,  inclination  to  anger. 

3.  Sexual  System,     a.   Enfeebled    condition,    manifested 
by    erethism     (sexual     instinct     without     energy), —  rapid 
emissions,  followed  by  great  exhaustion  and  apathy  after 
coitus. 

b.  Profuse  perspiration  about  the  genital  organs,  especially 
of  females ;  excoriation  and  itching. 

c.  Sepia  has  more  relation  to  the  female  sex,  yet  is  not  to 
be  overlooked  in  reference  to  the  male.     Menses  scanty  or 
suppressed,  or  else  occurring  too  early.     During  the  sup- 
pression of  the  menses  mental  depression  and  apathy. 

B.  Secondary.       I.    Nervous   System.      a.    The   nervous 
system,  especially  in  the  female  sex,  standing  in  the  closest 


NO.    X.      SEPIA.  319 

relation  to  the  sexual  system,  shows  a  tendency  to  erethism, 
in  consequence  of  which  hysteric  phenomena  present  them- 
selves, which  may  increase  even  to  spasms. 

b.  The  sensations  and  pains  of  Sepia  are  indistinct  in 
character,  and  are,  generally,  feelings  of  weakness,  apathy 
and  lassitude ;  sometimes,  however,  they  are  more  distinct, 
occurring  as  burning,  sticking  or  cutting  pains — especially 
in  the  loins  (corresponding  to  the  liver  and  sexual  system). 

2.  Vascular  System,     a.  Participates  slightly  in  the  effects 
of  Sepia,  except  in  the  easily  provoked  orgasms  of  blood  to 
the  head  and  chest     The   symptoms   chiefly  unimportant 
and  secondary. 

b.  Vascular  energy  is  diminished — so,  consequently,  is 
the  thermogenesis.  Subjective  and  objective  venosity; 
passive  congestions,  perspiration ;  palpitation,  pulsations 
felt  over  the  whole  body.  These  occur,  but  may  well  be 
regarded  as  phenomena  belonging  to  the  nervous  rather 
than  to  the  vascular  system. 

3.  Secretive  System.     Only  in  so  far  generally  affected,  as 
that   the    secretions    and    excretions   present   an    abnormal 
character,    having   a   tendency    to   become   sour  and   foul. 
They  are  sometimes  increased,  sometimes  diminished.     The 
increase  of  perspiration  is  most  marked. 

4.  Respiratory  System.     A  tendency  to  furnish  a  counter- 
poise to  the  general  condition ;  hence,  not  unfrequently,  a 
condition  of  irritation,  catarrh  with  even  bloody  expectora- 
tion, cough,  sometimes  dry,  sometimes  moist — irritation  of 
the  pleura. 

5.  Sexual  System.    The  physiological  connection  between 
uterus  and  mamma  is  here  manifested  by  the  emaciation  and 
flaccidity  of  the  mammae,  and  the  swelling  and  ulceration  of 
the  nipples. 

CHAR  A  CTERISTICS. 

I.  The  Jains  are  dull;  pain  like  paralysis  is  predominant. 
Amelioration  from  warmth  and  violent  motion.  Aggravation 
by  repose  and  at  night. 


320  DIAGNOSIS  IN   HOMOEOPATHIC   PRACTICE. 

2.  A  peculiar  cachectic  aspect ;  enfeebling  of  the  vegeta- 
tion. Predominant  affections  of  the  portal,  hepatic  and 
sexual  systems.  Especially  applicable  to  females.  Gener- 
ally menstruation  scanty,  suppressed,  or  precocious. 

APPLICA  TION. 

A.  General.      I.  Age.      Sepia   is   especially   adapted   to 
affections   occurring   at  the   climacteric   period,  in  women 
who  were  formerly  excitable ;  after  long-continued  depress- 
ing mental  affections,  or  great  bodily  or  mental  labor. 

2.  Aspect.     An  unmistakable  aspect ;    a  peculiar  yellow- 
ish puffy  complexion,  rather  fat.     The  tissues  are  soft  and 
flaccid ;  they  easily  and  quickly  collapse  and  soon  recover. 

3.  Temperament.     Good-natured,  yet  easily  excitable. 

4.  The    affections   complained    of  are    not  violent,  often 
disappearing  altogether,  and  are  concentrated  in  the  digestive 
and  sexual  sphere.     A  special  indication,  in  addition  to  the 
above,    is   a   very   slight   acrid   and    excoriating  discharge 
ex  genitalibus. 

5.  Although  especially  adapted  to  females,  Sepia  is  also 
applicable,  variatis  variandis,  to  the  male  sex,  especially  to 
woman-like,  soft-tissued  men,  who  were  formerly  of  a  fiery 
temperament,  but  have  settled  down  into  a  sedentary,  medi- 
tative mode  of  life. 

B.  Special.      I.  Affections  of  tJie  Digestive  apparatus  and 
the  Liver  indicate  Sepia,    a.  By  sour  and  putrid  formations, 
manifested  by  eructations  and  habitual  flatulence,  and  dis- 
turbed digestion.  Inveterate  sub-acute  pyrosis  (in  acute,  not 
appropriate, — compare  Ipecacuanha,  etc.).   Pains  in  the  stom- 
ach, and  cramps  of  the  stomach  and  intestines  after  eating. 

b.  Pains  in  the  hepatic  and  iliac  region,  excited  by  touch- 
ing those  regions ;  hence,  applicable  in  corresponding 
affections  of  the  liver  generally ;  in  degeneration  of  the  liver 
and  intestines,  Sepia  is  applicable,  at  most,  only  in  the 
beginning ;  later,  other  remedies  come  into  play.  ( Ascites 
as  secondary  to  hepatic  affection.) 


NO.    XL      GRAPHITES.  321 

2.  Sexual  System,     a.   Uterus.     Chronic  infarctus ;  indu- 
ration.    Acrid  discharge  ;  laxity  of  the  neighboring  parts  ; 
blennorrhoea,  prolapsus.     Amenorrhcea  and  dysmenorrhcea 
(menses  being  either  too  early  or  too  late,  and  too  weak). 
Sterility,    abortion,    displacement   of  the    uterus.     Mucous 
polypus. 

b.  Male  Sex.  Increase  of  sexual  instinct,  and  at  the 
same  time  loss  of  sexual  power.  Erethism  (in  both  sexes) ; 
hence,  frequent  nocturnal  pollutions,  followed  by  great 
exhaustion.  Chronic,  very  profuse,  corrosive  gonorrhoea. 

3.  Nervous  Affections.     Nervous  affection  of  the  abdom- 
inal   organs    and    uterus;    hence,    melancholia   and   actual 
hysteria  ;     megrim    easily   induced.      Nervous    toothache 
during  pregnancy  and  at  the  climacteric  period.     Irritatio 
spinalis  ;  and,  in  consequence,  paralysis  of  the  lower  part  of 
the  trunk. 

4.  Cutaneous  Affections.      Herpes    circinatus  ;    stinking 
perspiration  of  the  feet  (not  stinking,  Bryonia).     Psoriasis. 

5.  Affections  of  Eyes,  Ears,  and  Nose.     (As  far  as   the 
vascular  system  is  concerned).     Chronic   ophthalmia,  with 
acrid  secretion   (abdominal  ophthalmia,   according  to  Pro- 
fessor Rosas,  of  Vienna),  and  yellow  sclerotica.     Deafness, 
in    affections    of    the    liver    and    abdominal    organs.      In 
Ozoena,  a  very  important  remedy.     Ulceration  and  eruption 
about   the    mouth,  with    simultaneous   disturbance   of  the 
digestion. 

6.  Excretions.   Constipation/with  much  tenesmus.  Mucous 
diarrhoea  ;    stinking  cold  sweat  of  the  extremities. 

7.  Thoracic  Affections.     Tuberculosis.     Affections  of  the 
heart  depending  on  abdominal  disease.     Palpitation.    Inter- 
mittent fever,  cold  predominating.     Ulceration  of  the  feet 
Varices. 

NO.    XI.      GRAPHITES. 

Graphites  resembles,  in  many  respects,  its  chemical  sis- 
ters, the  Carbons;  less,   however,  in  its  general  character, 
22 


322  DIAGNOSIS   IN   HOMOEOPATHIC   PRACTICE. 

than  with  reference  to  certain  peculiar  symptoms.  Its 
action  is  very  extensive  and  energetic,  affecting,  in  a 
marked  degree,  the  entire  vegetative  sphere.  We  find,  in 
the  effects  of  Graphites,  all  the  phenomena  of  a  depressed 
vegetative  life,  and  a  diminished  assimilative  activity,  and 
can  only  remark,  as  a  specialty,  the  peculiar  tendency  to 
the  formation  of  pus.  This  specialty  will  be  noted  here- 
after. 

1.  Vegetative  Life.     Almost  no  remedy  attacks  this  sys- 
tem with  so  great  energy  in  proportion   to   the  degree  of 
reaction  which  it  excites.     In  tkis  respect,  Graphites  stands 
between  Arsenic    and   the    Carbons.     The   phenomena   of 
general  and  local  excitement  induced  by  it  are  pretty  clear, 
yet  are  only  to  be  explained  as  secondary ;  and  they  pro- 
ceed only  from  the  vascular  system,  and,  in  a  very  slight 
degree,  from  the  nervous  system. 

2.  Secretions.     In  general,  the  secretions  are  diminished 
and  thickened.     The  character  of  decomposition  is  manifest 
in   a    greater    or   less    degree ;    hence,    the    secretions   are 
offensive,   of   unnatural   color    and  repulsive    taste.     As    is 
always  the  case  when  the  character  of  decomposition  pre- 
vails, the  serous  secretions  are  increased. 

3.  Skin.     Here  we  see,  strongly  developed,  the  phenom- 
ena furnished  by  every  disease  which  manifests  a  tendency 
to  morbid  secretions, — viz. :  itching,  formation  of  pimples ; 
irritation,   with  bluish-red  papules  of   various  size,  having 
an    erysipelatous    aspect.       There    is,    however,    a   special 
tendency    to    erythema,    suppuration,    ulceration  ;    hence, 
serous    vesicles,    ulcers  discharging   pus    and   sanies,  moist 
eruptions,  rhagades,  scaly  ulcers  on  all  parts  of  the  skin, 
and  on  its  transitions  to  mucous  membrane,  especially  about 
the  mouth. 

4.  Mucous  Membranes.     In  the  mucous  membranes,  this 
character  of  Graphites  is  still  more   distinctly  manifested. 
Their  secretion  is,   for  the  most  part,   diminished  ;    hence, 
they  become  dry.     The  secretions  assume  a  thick,  tenacious 


NO.    XL      GRAPHITES.  323 

character,  are  difficult  of  solution  (or  excretion),  and  have 
a  foul,  saltish  taste. 

(i.)  The  Eye  becomes  turbid  and  dry,  the  lids  cohere ; 
they  burn  and  are  irritated. 

(2.)  In  the  Ear,  a  similar  condition  is  manifested;  buzzing 
in  the  ear,  and  deafness. 

(3.)  Dryness  of  the  Nose,  inclination  to  sneeze,  loss  of 
smell,  or  a  foul  odor  constantly  in  the  nose. 

(4.)  Mouth  and  Throat.  Coated  tongue;  sensation  as  of 
something  fixed  in  the  throat ;  frequent  endeavors  to  hawk 
up  something  ;  dryness  of  throat,  hoarseness,  tickling,  burn- 
ing, rawness  ;  dyspnoea,  anxiety,  dry  laborious  cough. 

(5.)  Intestinal  Tract.  Diminished  stools;  dryness  and 
burning  in  the  urethra  and  vagina ;  difficult  and  painful 
micturition. 

The  tendency  to  ulceration  appears  most  distinctly  in 
those  mucous  membranes  which  are  in  more  immediate 
contact  with  the  atmosphere ;  hence  ulcerative  pain,  with 
vesicles,  pustules  and  ulcers,  and  corresponding  discharges 
from  nose  and  mouth. 

5.  The  Urinary  Secretion  is  either  diminished  or  increased; 
more  frequently  diminished. 

6.  Menstruation.  Diminished,  retarded,  enfeebled  (Hahne- 
mann). 

7.  The    Seminal    Secretion   is   likewise   scanty,   or    fails 
entirely ;   hence  diminished  sexual   instinct,  and   imperfect 
ejaculation  of  semen. 

8.  Assimilation.      Graphites    diminishes  the  assimilative 
action,    inasmuch  as   the    part   destroyed  by   its  primary, 
decomposing  action  is  not  perfectly  restored  ;  while  at  the 
same  time  it  enlarges  it,  inasmuch  as  it  induces  abnormal 
deposits  and  secretions.     The  altered  blood-crasis  does  not 
permit   a  sufficient  ^generation  of  the  removed  portions; 
hence  the  vital  turgor  sinks,  the  tissues  lose  their  elasticity  ; 
while  the  new  tissues  do  not  arrive  at  textual  completeness. 
Hence  ensue  collapse,  flabbiness,  discoloration  of  skin  and 


324  DIAGNOSIS   IN   HOMCEOPATHIC   PRACTICE. 

mucous  membranes,  loss  of  epidermis,  falling  out  of  the 
hair. 

Circulation  is  generally,  at  first,  in  a  state  of  excitement ; 
hence  sometimes  a  general  storm,  but  more  frequently 
partial  congestions  present  themselves.  Soon,  however,  the 
circulation  loses  energy,  becomes  slow,  idle,  weak.  As 
everywhere,  under  such  circumstances,  so  here  also  appear 
soon  an  increased  venosity,  and  then  stases  in  the  capillary 
vascular  system,  which  lead  to  exudations  in  the  form  of 
oedema,  ecchymosis,  vesicles,  etc. 

In  the  lymphatic  system,  the  same  process  goes  on  ;  hence 
swelling  of  the  glands,  induration,  and  irritation.  In  this 
condition,  a  corresponding  fever  is  evident,  in  which  the 
cold  predominates,  the  heat  being  less  general  and  less 
violent ;  coldness  of  greater  part  of  the  body,  and  heat  only 
here  and  there.  Sweat  and  thirst,  especially  thirst,  are  often 
violent,  and,  as  in  all  enfeebled  conditions,  are  easily  and 
speedily  provoked  by  slight  causes. 

The  nervous  system  partakes  very  little  in  the  action  of 
Graphites,  since  this  action  is  not  excessive,  rapid,  nor 
violent  The  phenomena  that  do  occur  are  chiefly  those  of 
depression  ;  hence  the  cerebral  activity  is  markedly  impaired. 

The  general  sensation,  according  as  it  does  with  the 
condition  of  the  vegetative  life,  is  depressed ;  hence  gen- 
eral weakness,  lassitude,  relaxation  of  the  tissues.  Syncope 
is  easily  induced,  together  with  great  anxiety.  On  this 
account  the  feeling  of  lassitude  is  altogether  the  predominant 
general  sensation ;  the  other  varieties  of  pain  not  being 
constantly  produced  by  Graphites,  but  being  due  to  the 
local  conditions  induced  by  it.  The  activity  of  the  motory 
functions  is  impaired ;  these  functions  lack  energy,  but  their 
debility,  never  amounts  to  more  than  a  very  slight  degree 
of  paralysis ;  while,  on  the  other  hand,  convulsive  jerkings, 
tremblings,  and  spasmodic  phenomena  are  not  unfrequently 
present. 

Particular  Functions.     I.  Digestion  is  impaired.  Graphites 


NO.   XL      GRAPHITES.  325 

has  an  especial  relation  to  this  process ;  for  several  symp- 
toms are  peculiar  to  Graphites,  viz. :  salt,  sour,  foul  taste  in 
the  mouth,  aversion,  especially  to  meat  and  salt  food,  and 
disinclination  to  other  articles  of  food  ;  unpleasant  sensation 
before  eating;  during  a  meal,  immediate  unpleasant  effects, 
especially  abdominal  distension,  borborygmi ;  after  eating, 
many  sufferings,  burning,  sticking,  and  stomach  cramp, 
singultus,  nausea ;  many  marked  secondary  symptoms. 

2.  Intestinal  Canal.  At  the  same  time  with  above  digest- 
ive phenomena,  great  meteorismus,  discharges  of  flatus,  and 
cramps. 

Liver  and  Spleen.  Pain  ;  bilious  vomiting.  Stool  gen- 
erally retained  solid,  of  a  horribly  offensive  character ; 
seldom  watery. 

Anus.  Burning  and  pinching.  Prolapsus,  discharges  of 
blood ;  haemorrhoidal  tumors. 

Urine.  The  urinary  and  genital  systems  are  markedly 
affected.  * 

APPLICATION. 

Graphites  is  applicable,  according  to  special  indications,  in 
both  acute  and  chronic  diseases ;  more  frequently  in  chronic. 
The  acute  conditions  in  which  it  is  indicated  cannot  be 
strictly  and  purely  such,  but  rather  be  conditions  growing 
out  of  a  chronic  diseased  state,  corresponding  in  general 
character  to  Graphites.  Its  province  is  the  more  highly 
developed  affections  of  the  vegetative  sphere,  and  we  might 
in  this  view  call  Graphites  a  high  potency  of  sulphur ;  for 
no  small  number  of  symptoms  is  common  to  both  remedies  ; 
in  Graphites,  however,  they  reach  a  higher  grade  of  develop- 
ment. This  intermediate  position  of  Graphites  between 
Sulphur  and  Arsenic  and  Carbon,  indicates  its  very  extended 
sphere  of  action,  which,  however,  is  distinct  from  that  of  the 
others,  inasmuch  as  Graphites  has  so  marked  a  tendency  to 
the  ulcerative  and  corresponding  processes. 

Diseases  in    General.      i.    Cutaneous  Affections.     Those 


326  DIAGNOSIS   IN   HOMCEOPATHIC   PRACTICE. 

which  are  disposed  to  suppuration.  Ulceration  with  a 
peculiar  scanty  discharge,  and  formation  of  fungous  granu- 
lations (hence  panaritis).  This  ulcer  is  not  easily  healed  — 
presents,  however,  a  certain  degree  of  vitality,  even  of 
irritation ;  hence  granulations  form,  or  at  least  there  is  an 
evident  tendency  to  their  formation.  Scrofula  and  tubercle 
do  not  generally  correspond  to  Graphites,  yet  may  do  so  in 
individual  forms,  which  are  not  infrequent. 

Arthritis.  Graphites  is  one  of  the  very  first  remedies, 
especially  where  there  is  no  deposit,  or  a  very  slight  one, 
when  it  is  probable  that  the  sero-nbrous  tissues,  by  their 
dryness,  aggravate  the  condition. 

Diseases  in  particular.  I.  Skin  is  especially  the  province 
of  Graphites.  Its  distinctive  character  is  this :  a  product 
forms,  the  epidermis  is  removed,  pustules  and  vesicles  form 
and  re-form,  or  disappear,  and  are  succeeded  by  scales ;  the 
pustules  or  scales  fall  away,  and  leave  a  raw  place,  difficult 
to  heal,  and  generally  covered  by  a  certain  amount  of 
secretion,  which,  in  the  air,  dries  to  a  scab,  scale,  or  mem- 
brane, and  covers  the  spot.  Moreover,  cutaneous  secretions 
are  produced,  which  thicken  and  elevate  the  epidermis,  and 
form  granulations  of  various  kinds  (horny,  panaritic  fungi). 
Finally,  to  Graphites  belong  those  skin  diseases  which  are 
followed  by  successive  crops  of  little  vesicles,  which  scab 
over  and  so  gradually  cover  large  surfaces.  In  this  category 
belong  eczema,  herpes,  impetigo,  lichen  (?),  in  the  lower 
grades;  psoriasis,  pityriasis,  ichthyosis,  scaly  eruption  on 
the  head,  and  falling  out  of  the  hair.  Among  the  maladies 
not  herein  included,  and  in  which  Graphites  is  indicated,  is 
erysipelas,  which  frequently  returns,  or  has  so  slow  a  migra- 
tion that  gradually  almost  the  whole  body  is  covered  by  it. 

2.  Eyes.     Often  recurring  inflammation,    especially  with 
formation  of  ulcers.     Scrofulous  ophthalmia,  with  cohesions 
of  the  lids  and  photophobia,  especially  in  conjunction  with 
crusta  lactea.     Dryness  of  the  conjunctiva. 

3.  Ears.     Deafness,  buzzing  in  the  ears,  when  in  a  gouty 


NO.    XII.      IPECACUANHA.  327 

constitution,  but  especially  when  there  is  reason  to  suspect 
dryness  of  the  mucous  lining  of  the  ear,  as,  for  example, 
simultaneous  dry  catarrh  of  the  nose,  pharynx,  etc. 

Toothache,  with  swelling  and  ulceration  of  the  gums. 

Ulcers  of  the  Month.  Especially  with  offensive  swellings 
of  the  glands  of  the  throat;  frequent  angina,  with  conse- 
quent ulceration. 

Dyspepsia. 

Chronic  Gastritis  (Ulcus  perforans).  Flatulence  very 
great.  Constipation,  with  occasional  diarrhoea ;  chronic 
colic. 

Genitalia.     Swelling  of  prepuce,  especially  in  children. 

Herpes  Prtzputialis.  Burning  on  micturition.  Want  of 
semen  and  lack  of  sexual  instinct ;  swelling  and  induration 
of  testes.  Hydrocele.  Enlarged  ovaries ;  amenorrhcea ; 
Menses  scanty,  delayed,  and  painful. 

Respiratory  Organs.  Dryness  of  mucous  membrane; 
hence  chronic  catarrh  in  many  cases  of  tuberculosis ;  great 
roughness  and  hoarseness  of  the  voice  ;  sensibility  of  larynx 
or  quick  respiration,  and  on  change  of  temperature,  inducing 
a  tickling  and  spasmodic  cough. 

N.  B.  Applicable  to  the  pyaemic  and  uraemic  processes ; 
to  affections  of  the  liver  without  degenerations. 


NO.  XII.  IPECACUANHA. 

Belongs  to  that  class  of  remedies  which  act  chiefly  on  the 
nervous  system.  Its  action  is  very  moderate  in  degree; 
hence  not  very  striking.  Its  exciting  action  is  exerted 
chiefly  on  the  thoracic  plexus ;  it  stands  therefore  in  a  kind 
of  opposition  to  Nux  vomica,  which  affects  rather  the 
subdiaphragmatic  ganglia. 

I.  Nervous  System.  The  brain  and  spinal  system  are 
scarcely  affected;  at  most  they  are  affected  only  by  a  reflex 
action.  Still  less  is  the  sensorium  acted  upon.  Little  or  no 


328  DIAGNOSIS   IN   HOMCEOPATHIC   PRACTICE. 

pain  is  induced  ;  at  most  it  is  secondary.  The  symptoms  of 
spasm  are  more  numerous  and  better  marked.  Character. 
The  symptoms  reveal  a  distinctly  intermittent  character, 
in  which  they  are  rivaled  only  by  Nux  and  Pulsatilla.  The 
pains  suddenly  appear  and  suddenly  disappear.  They  are 
aggravated  at  night  (because  the  vegetative  sphere  is 
especially  affected).  For  the  same  reasons,  similar  symptoms 
occur  at  the  same  time  in  various  parts  of  the  body. 
Gastric  phenomena  are  always  present ;  and  organic  sensation, 
i.  e.,  consciousness  of  defined  organic  conditions,  in  a  high 
degree;  e.  g.,  nausea,  constant  constriction  of  the  chest, 
premonitions  of  spasms,  constrictive  sensations  in  the  salivary 
ducts,  in  the  urinary  and  sexual  organs. 

2.  Vascular  System.     Great   analogy    to  Nux.     Ipecac- 
uanha has  little   effect  on    the  great  vessels  and  the  heart 
(Nux  affects  the  capillary  system  and  the    great  vessels  at 
the  same  time);  it  has  more  especial  affinity  to  the  capillary 
vascular  system  alone  ;  hence  external  coldness,  and  internal 
heat,  and  vice  versa,  objective  heat,  but  subjective  coldness 
of  the  skin,  and  vice  versa. 

3.  Vegetation.     Ipecacuanha  excites  and  alters  the  vege- 
tation.    The  secretions  are  in  general  diminished  in  quantity ; 
in   quality   they   are   scarcely   altered.       There    seems   to 
be  no  connection  or  mutual  dependence  between  objective 
and  subjective  phenomena.     Sweat,  urine,  saliva,  are  for  the 
most    part   increased;    other   secretions,    which    require    a 
greater  elaboration,  for  example,  those  of  mucous  membranes, 
are  diminished.     Bile  is  generally  increased.     Haemorrhages 
are  frequent  (because  of  the  action  of  Ipecacuanha  on  the 
capillary  system),  yet  no  profuse  discharge  of  undecomposed 
blood,  threatening  the  organism.     Ipecacuanha  affects    the 
stomach  and  chest,  but  acts  less  strongly  on  the  intestines. 
Nausea,  inflation,  constrictive  sensation,  vomiting  (scanty), 
without  giving  relief,  and  the  matters  vomited    not  qualita- 
tively altered.     Foul  taste,  scratched  feeling  in  the  throat, 
yet  the  tongue  not  foul,  etc.     The  peristaltic  action  of  the 


NO.   XII.      IPECACUANHA.  329 

bowels  is  diminished  ;  the  antiperistaltic  increased ;  constipa- 
tion, also  watery  diarrhoea. 

Lungs.  More  important  action,  constriction,  dyspnoea, 
irritation  inducing  cough,  increased  sensibility,  spasm, 
diminished  secretion. 

Application.  To  pale,  blonde  individuals,  women  and 
children.  Disturbance  of  the  vegetative  nervous  system,  of 
the  stomach  and  lungs  at  the  same  time. 

Special.  I.  Disorder  of  the  stomach  after  an  excess,  if  the 
disturbance  continue  some  time  (for  the  more  transient 
disorders,  Nux  vomica,  Pulsatilla,  etc.).  After  typhus  and 
intermittent  fever,  for  the  remaining  stomach  affections, 
chronic  nausea,  and  vomiting.  Indisposition  after  eating, 
yet  without  loss  of  appetite.  In  particular  the  gastric 
phenomena  of  pregnancy.  All  these  ailments  are  generally 
conjoined  with  chest  affections,  anxiety,  constriction,  etc. 

2.  Acute  affections.     Variola,  morbilli,  catarrh,  in  its  last 
stages. 

3.  Intermittent  fever.       It     ranks    with    Nux     vomica 
Pulsatilla,  and  China,  as  one  of  the  best   remedies.     The 
fever  in  which   it  is  indicated  is  characterized  by  gastric 
phenomena  of  low  intensity ;  the  chill  predominates,  and  the 
chest  also,  is  affected ;  the  patient  feels  as  if  a  hoop  were 
placed  around  the  body. 

4.  Nervous  fever  in  the  beginning;  cholera  in  the  begin- 
ning ;  and  in  the  sequelae  of  cholera. 

5  Hemorrhage,  from  partial  over-excitements,  especially 
in  incipient  tuberculosis  in  young  girls;  also  in  haemorrhage 
from  paralysis  of  the  capillary  vascular  system,  but  never  in 
haemorrhage  arising  from  general  crasis,  or  decomposition. 
Seldom  in  haemorrhage  from  the  stomach  and  intestines; 
oftener  in  that  from  the  lungs  and  nose. 

6.  After  the  violence  of  acute  pulmonary  affections  has 
abated,  when  irritation  remains.  In  chronic  catarrh  with 
physical  symptoms  of  a  very  low  grade ;  when  the  irritation 
inducing  cough,  and  the  dyspnoea  are  great  at  periodic 


330  DIAGNOSIS   IN   HOMOEOPATHIC    PRACTICE. 

intervals;  hence,  in  all  asthmatic  cases.  In  all  coughs  with 
a  tendency  to  vomiting,  if  not  violent,  even  in  a  slight 
degree.  Spasms  during  pregnancy.  Abuse  of  China. 


NO.  XIII.     CHINA. 

China  has  much  in  common  with  Arsenic  and  Carbo 
vegetabilis.  It  develops  its  effects  on  the  vitality  of  the 
blood  ;  debility  ensues,  like  that  induced  by  venesection,  in 
which  the  quantity  and  quality  of  the  blood  are  altered, 
and,  in  consequence,  various  functional  disturbances  mani- 
fest themselves.  The  entire  vegetation  suffers,  the  tone  of 
the  organism  becomes  enfeebled,  the  blood  becomes  thin 
and  watery,  and  the  circulation  lacks  energy  ;  hence  ensue 
stases,  haemorrhage,  watery  diarrhoea,  abundant  sweat  and 
urine. 

Circulation.  The  energy  of  the  circulation  is  diminished  ; 
the  pulse  becomes  small  and  weak  in  consequence  of  the 
anaemia ;  hence,  erethism  and  debility.  (Carbo  induces 
debility,  with  torpor ;  Arsenic,  debility,  with  excitation, 
presenting,  therefore,  a  closer  analogy  to  China.)  The  veins 
become  varicose  ;  the  arteries,  however,  retain  their  tone. 

Nervous  System.  Erethistically  affected.  Greatly  in- 
creased sensibility  to  all  external  influences.  (China  induces 
greater  sensitiveness  of  the  scalp  to  external  touch  than 
any  other  remedy  does.)  The  affection  of  the  nervous 
system  exercises  a  reflex  action  on  the  blood ;  hence,  also, 
excitation  alternating  with  depression.  (Belladonna  induces 
a  continuous,  enduring  excitation.) 

Vegetation.  The  whole  vegetation  appears  depressed,  the 
vital  turgor  diminished.  The  skin  is  pale  and  earthy,  the 
vessels  being  visible  through  it.  The  digestive  function  is 
modified.  For  the  liver,  China  has  a  special  affinity,  as 
well  as  for  the  spleen,  in  enlargement  of  which  a  small 
dose  of  China  effects  a  speedy  diminution  of  volume. 


NO.    XIII.      CHINA.  331 

China  induces  hyperaemia  of  both  of  these  organs ;  the 
diminution  is  therefore  a  secondary  effect.  (Piorry's  experi- 
ments.) 

To  the  Stomach,  China  bears  important  relations  (espe- 
cially to  the  solar  plexus),  enfeebling  its  activity,  inducing 
loss  of  appetite,  without  vitiating  the  taste.  Nausea,  and 
disinclination  for  certain  articles  of  ordinary  diet,  result  from 
the  altered  digestive  activity  and  the  altered  secretions ;  in 
particular,  water-brash,  in  consequence  of  the  watery  secre- 
tions. The  rest  of  the  digestive  canal  is  but  little  affected  ; 
watery  stools,  however,  occur,  in  consequence  of  intestinal 
paralysis  ;  hence,  also,  Lienteria. 

To  the  Lungs  and  Genital  Organs,  China  has  no  special 
relations.  The  secretions  of  the  mucous  membranes  are 
watery  and  thin  (cedema  pulmonum).  It  is  not  specifically 
indicated  in  anasarca,  and  it  induces  vesicles  (miliaria)  only 
by  inducing  a  general  debility.  To  the  uterus,  no  especial 
affinity.  The  menstrual  flow  is  increased  in  quantity  and 
in  fluidity,  with  general  weakness  and  anaemia. 

Characteristic  Symptoms.  I.  Pains.  Sticking,  tearing, 
drawing,  in  particular  lassitude,  with  a  peculiar  restlessness, 
impelling  to  constant  motion.  Pain,  as  if  after  a  journey 
on  foot. 

2.  Aggravation.     By  touch,  motion,  and  by  every  kind 
of  physical  or  mental  effort. 

3.  Very  great  sensitiveness  to  external  influences,  espe- 
cially of  the  skin  and  the  head,  to  the  external  touch. 

4.  Yellow,  earthy  hue  of  the  skin. 

5.  Fever,   chill  predominating  ;  heat  and  cold  but  par- 
tially distributed.     Thirst  during  the  cold,  and  between  it 
and  the  heat 

6.  Pulse  generally  quick,  small,  and  soft. 

7.  Thirst  during  the  cold  stage. 

8.  Gastric  affection  ;  water-brash. 

9.  Swelling  and  pain  of  liver  and  spleen. 

10.  Diarrhoea,  watery  and  soft :  slowly  expelled. 


332  DIAGNOSIS  IN   HOMCEOPATHIC   PRACTICE. 

11.  Menses  generally  increased,  but  thin  and  watery. 

12.  Symptoms  periodic  in  character. 

13.  Feeble  condition  after  loss  of  vital  juices,  after  haemor- 
rhages, sweat,  pollutions,  onanism,  etc. 

SPECIAL  INDICATIONS. 

1.  After  all  enfeebling  maladies  (intermittent  and  nervous 
fever,  etc.). 

2.  After  great  loss  of  fluids. 

3.  After  mental  exertions,  night  watchings,  etc. 
(i.)  In  atrophia  infantilis  and  senilis. 

(2.)  In  haemorrhages,  only  when  they  depend  on  debility, 
on  torpor  of  the  vessels,  and  fluidity  of  the  blood. 

4.  In  chlorosis,  China  compares  with  Pulsatilla  and  Fer- 
rum. 

(i.)  Pulsatilla  is  indicated  when  paleness  predominates, 
where  emaciation  is  not  yet  marked,  and  where  the  turgor 
vitalis  is  still  present.  Fluor  Albus. 

(2.)  China,  where  there  is  a  yellowish  hue,  gastric  symp- 
toms are  conjoined,  and  the  turgor  vitalis  is  going  or  quite 
gone. 

(3.)  Ferrum,  where  there  are  vascular  erethism,  fugitive 
flashes  of  heat,  diminished  menstrual  flow,  but  the  blood  of 
a  bright  red  color. 

5.  Hy drops  from  atony  and  anaemia. 

6.  Sequelae  of  liver  disease.     Ascites. 

7.  Sequelae  of  cutaneous  disease.     CEdema,  cyanosis. 

9.  Typhus  seldom,  and  only  when  accompanied  by  their 
bilious  diarrhoea. 

9.  Sequelae  of  cholera. 

10.  Intermittent  fever.  The  experience  of  allopaths  shows 
that  in  this  disease  we  should  not  neglect  China.    Dr.  Kaspar 
says  he  gives  China   in  all  cases  of  intermittent  fever,  in 
which  no  other  remedy  is  clearly  indicated,  even  though  the 
indication  be  not  very  clear  for  China.    The  enlarged  spleen 
diminishes  in  a  short  time  and  permanently. 


NO.    XIV.      PHOSPHORUS.  333 

11.  Gastric  and  bilious,  according  to  their  form.     Gas- 
tralgia. 

1 2.  Affections  of  liver  and  spleen.  Enlargement  of  the  liver. 

13.  Lienteria,    a   cardinal   remedy.      (Weakness   of   the 
intestinal  canal — a  too  thin  gastric  secretion.) 

14.  Nocturnal   pollutions   too   frequent.     Amenorrhoea ; 
abortion ;  delayed  parturition ;    chlorotic  palpitation  of  the 
heart.    With  reference  to  general  sensibility ;  compare  China 
with  Cocculus  and  Ignatia. 


NO.    XIV.    PHOSPHORUS. 

Phosphorus  acts  directly  upon  the  blood-life,  modifying  it 
in  a  remarkable  manner,  producing  a  tendency  to  decom- 
position, and  causing  ecchymosis,  haemorrhage  and  depositions 
in  the  parenchymatous  organs.  The  pus.  of  which  it  induces 
the  formation  is  intermediate  between  true  pus  and  sanies. 
Phosphorus  induces,  in  particular,  a  violent  erethistic  con- 
dition of  the  whole  vital  process,  acting  first,  upon  the 
nervous  system,  then  by  a  reflex  action  upon  the  vascular 
and  the  remaining  system,  and  causing  in  its  subsequent 
action,  apathy,  torpor,  and  paralytic  conditions. 

1.  Vascular    System.      Erethism    is    distinctly    marked. 
Sometimes    it    is     general ;     sometimes    partial,    affecting 
especially   the    head    and    chest;    chills    predominate,    but 
excessive  heat  is  often  induced,  and  these  sensations  alter- 
nate quickly  with  each  other.     Sensations  resulting  from  a 
partial  erethistic  condition  in  the  head  and  chest  accompany 
almost  all  other  symptoms.     Throbbing  of  the  vessels  of  the 
head  (also  Belladonna).     The  general  temperature  is  much 
elevated.     Thirst   may   be   increased  or   absent.     Sweat   is 
much  increased. 

2.  Nervous  System.     Much  excited.     This  excitement  is 
manifested  in  gayety  and  levity,  in  diminished  sleep  without 
consequent  suffering ;  in  restlessness  and  dreamful  sleep,  in 


334  DIAGNOSIS   IN   HOMOEOPATHIC   PRACTICE. 

entire  sleeplessness,  even  in  delirium.  The  fantasy  is  exalted. 
In  the  further  action  of  Phosphorus  apathy  is  induced ;  the 
mental  activity  and  ability  are  diminished ;  trembling  and 
jerking  of  the  muscles  are  frequent,  especially  of  the  muscles 
of  the  head,  face  and  neck. 

3.  Nutrition.     Impaired — as 'shown  by  the  earthy  com- 
plexion,  with  the    peculiar  yellow   tint,  recognized    in   the 
Phosphorus    degeneration.      The    turgor   vitalis    is    at   first 
increased,  then  depressed,  emaciation  resulting.     The  Secre- 
tions are  in  general  diminished,   even  to  dry  ness.     (Sweat 
and  urine  are  (mechanically  ?)  increased). 

4.  Skin.     Phosphorus  has  little  affinity  for  the  skin.     It 
induces  the  formation  of  papules  and  of  ulcers,  especially  on 
the  points  of  transition  between  the  mucous  membrane  and 
the  skin,  and    in   the  hollows  of  the  joints    (this    is    very 
characteristic).     Ecchymoses. 

5.  Eyes.     Irritation,  swelling,  the  conjunctiva  is  reddened, 
and  the  cornea  is  rendered  opaque;  the  globe  of  the  eye 
enlarges,  and  vesicles  form  in  and  around  the  eyes ;  in  con- 
sequence, sensations  as  of  clouds  and  sparks  before  the  eyes 
are  induced,  with  a  sensation  as  of  sand   in  the  eye,  and 
twitching  of  the  eyelids. 

6.  Ears,     Dryness. 

7.  Nose.     Dryness,  ulceration,  sticking,  efflorescence  around 
the  nose. 

8.  Month.     Dryness,    furred    tongue,    vesicles,    aphtJice, 
difficult  deglutition  (because  of  the  dryness).     The  pharynx 
is  irritated  and  inflamed. 

9.  Digestion.     Disturbed,  as  is  shown  by  loss  of  appetite, 
disgust,  nausea,  scanty  vomiting,  acrid  eructations. 

10.  Excretions.     Sensation    of  heat   through  the   whole 
intestinal  track,  even  to  burning,  relieved  by  Coffee.     Various 
pains.     Great  development  of  gas  (meteorismus  tympanitis). 
Stools  are  scanty,  of  a  pappy  nature,  green,  also  gray,  thin 
and  frequent.     Sometimes   they   are    difficult   and   painful, 
attended  by  tenesmus  and  burning  in  the  anus. 


NO.    XIV.      PHOSPHORUS.  335 

11.  Respiratory  Organs.     A  Specific  Action.     Phosphorus 
induces    great    dryness,    roughness,    hoarseness,    laborious 
cough,  with  a  scanty,  tenacious,  muco-purulent  and  bloody 
expectoration.     The  respiration  is  accelerated,  with  a  feeling 
of  constriction,  heat,  congestion  and  sticking  pain. 

12.  Genito-  Urinary    Organs.     Inflammation  of  the  kid- 
neys (?).     Diminution  or  increase  of  the  urine ;  burning  in 
the  urethra,  or  involuntary  micturition.     The  sexual  instinct 
is    increased,    showing    itself    in   priapism,    nymphomania, 
pollution,  powerless  coitus,  etc.     Menstruation  is  too  early 
and  too  copious. 

13.  Bones.     Phosphorus  exerts  a  specific  action,  especially 
on  the  jaw-bones,  inducing  inflammation  and  suppuration, 
with  a  simultaneous  formation  of  callus. 

APPLICA  TION. 

Phosphorus  is  indicated  as  well  in  acute  as  in  chronic  cases, 
— rather  in  acute  diseases.  In  all  conditions  of  nervous  and 
vascular  irritation  with  debility, — hence  in  erethistic  con- 
ditions it  stands  before  all  other  remedies.  In  the  diseases 
in  which  it  is  applicable,  the  transition  is  always  easy  to 
torpor  ;  there  is  always  a  dyscrasia,  approaching  in  character 
the  Typhoid  dyscrasia. 

Special  Application.  i.  In  typhus.  The  Phosphorus 
pathogenesis  is  a  perfect  picture  of  erethistic  typhus  (cerebral 
and  abdominal).  It  is  to  be  compared  with  Arsenicum, 
which  produces  collapse,  decubitus,  and  colliquative  diarrhoea, 
and  is  thereby  distinguished  from  Phosphorus,  which  has  no 
diarrhoea. 

In  pneumo-typhus,  where  the  diagnosis  hesitates  between 
tuberculosis  and  typhus.  In  all  cases  in  which  inflamma- 
tion takes  on  a  nervous  character,  e.  g.,  dysentery,  pyaemia, 
acute  catarrh,  with  nervous  symptoms. 

2.  To  inflammation  of  mucous  membranes  Phosphorus  has 
a  peculiar  affinity,  with  a  scanty  muco-purulent  secretion. 
Hence,  in  ophthalmia  with  general  vascular  excitement ;  in 


336  DIAGNOSIS  IN  HOMOEOPATHIC  PRACTICE. 

pneumonia  tuberculosa  (frequent  in  Phosphorus  factories),  in 
gastritis,  enteritis,  nephritis,  and  haematuria,  with  dark, 
scanty,  turbid  urine. 

3.  Ostitis  and  necrosis,  especially  of  maxillary  bones. 

4.  Rheumatism.     In  bone  diseases  depending  on  rheuma- 
tism.    In  diseases  assuming  a  chronic  form. 

1.  Day-blindness;    photophobia,  with  spots  and    sparks 
before  the  eyes.     Otitis,  with  deafness  after  nervous  fevers. 
Polypus  nasi.     Dental  caries. 

2.  Priapism,  impotence ;  amenorrhcea. 


NO.  XV.      CHAMOMILLA. 

Chamomilla  affects  directly  both  the  animal  and  vegetable 
nervous  systems, — the  latter  in  a  greater  degree.  It  acts 
more  decidedly  on  the  sensitive  than  on  the  motory  sphere. 
Like  Ignatia,  it  has  no  violent,  long-enduring,  or  deep-felt 
action.  Nevertheless,  by  a  long  use  of  it,  the  vegetation  is 
seriously  affected. 

GENERAL  ACTION. 

1.  In  the  animal  nervous  system.     Motory  sphere.     Slight 
spasms,  or  rather  tremblings  and  twitchings,  of  short  dura- 
tion.    The  parts  among  which  the  middle  spinal  nerves  are 
distributed  appear  most  strongly  affected. 

2.  Vegetation. — The  sensitive  sphere  is  more  affected  than 
the  motory.    I.  Spasm  occurs  also  in  the  vegetative  muscular 
system;  but  of  a  very  feeble  character.    2.  Pain  in  stomach 
and   intestines   is  very  considerable.     When  spasm  occurs, 
pain  is  always  present  predominating  over  the  spasm  (colic), 
and  very  often  pain  occurs  without  spasm. 

First  the  gastro- intestinal  sphere  is  affected, — then  the 
thoracic. 

i.  Stomach.  Dull  sensations,  pain,  often  also  spasm. 
Violent  nausea  interfering  with  appetite.  Singultus  when 


NO.    XV.      CHAMOMILLA.  337 

eating,  ructus,  vomituritio,  vomitus, — all  this  being  attended 
by  more  or  less  pain.  Sensation  of  fullness  when  the 
stomach  is  empty,  and  vice  versa.  Anxiety  in  the  epigas- 
trium after  eating  ;  drawing  pains  in  the  loins  and  hypochon- 
dria ;  accumulation  of  saliva  in  the  mouth  ;  alienated  taste ; 
sometimes  even  vertigo ;  loss  of  sense.  Hence,  in  general, 
aggravation  after  eating. 

2.  Intestine.    Pain,  flatulence,  peristaltic  motion  increased, 
anti-peristaltic  motion  induced. 

3.  Chest.      Increased   irritability   of    the   lungs;    hence 
tickling,  constriction,  and  anxiety. 

4.  Brain.  Irritability,  anger,  chagrin,  restlessness,  anxiety, 
weeping,  groaning,  fright,  crying  out,  speaking  during  sleep, 
and  sudden  starting,  especially  in  children. 

5 .  Vascular  System.    Easily  excited  ;  hence  frequent  con- 
gestions of  short  duration.     Contradiction  of  the  objective 
and  subjective   symptoms,  e.  g.,  external  cold,  and  internal 
heat,  as  in  the  case  of  Ignatia ;  Chamomilla,  however,  has 
pain  and  greater  disturbance  of  sensation  than  Ignatia,  and  its 
vascular  excitement  is  greater,  amounting  to  a  considerable  de- 
gree of  fever,  even  to  delirium,  and  attended  by  violent  thirst. 

6.  Blood.     Little  affected,  unless  by  a  long  use  of  Chamo- 
milla,  which    renders  the   blood   less   plastic   and   induces 
chlorosis. 

7.  Secretions.    Not  altered,  only  increased,  especially  those 
of  the  intestines  and   liver ;    in  consequence  of  the  latter 
effect,  the  excretions  are  more  green  in  appearance,  and 
increased  in  quantity.     Development  of  flatus. 

8.  Female  Sexual  System.     Although  this  system  is  not 
specifically  affected,  yet  the  menses  and  sexual  instinct  are 
increased. 

9.  Aggravation  of  the  pains  by  rest  and  warmth. 

APPLICATION. 

Chamomilla    is  applicable   in    erethism    of  the   sensitive 
nervous  spheres ;  hence,  peculiarly  appropriate  for  children, 
23 


338  DIAGNOSIS  IN   HOMGEOPATHIC  PRACTICE. 

and  for  women,  especially  during  pregnancy ;  for  persons  of 
irritable  temperament,  prone  to  congestion,  after  chagrin 
and  anger.  Among  children's  diseases,  it  is  especially 
appropriate  for  such  as  result  from  the  use  of  milk  either 
always  bad  or  rendered  so  temporarily  by  a  fit  of  anger  on 
the  part  of  the  nurse, — inducing  vomiting,  cuttings  in  the 
abdomen,  etc.  Chamomilla  may  be  used,  when  indicated, 
in  all  diseases,  except  in  conditions  of  torpor  and  synocha, 
or  of  great  excitation ;  hence,  in  sub-acute  conditions, 
hysteria,  certain  odontalgiae,  with  jerkings  and  distortion  of 
the  face,  aggravated  by  warmth ;  in  sub-acute  rheumatism; 
in  mastitis.  In  erysipelas  faciei  it  is  renowned.  In  inter- 
mittent fever,  with  abdominal  symptoms  characteristic  of 
Chamomilla.  In  diarrhoea,  with  violent  pains ;  abdominal 
spasms  before  the  evacuation ;  stools  pappy,  watery,  acid 
and  bilious.  In  gastric  affections,  especially  after  chagrin 
and  anger,  with  much  thirst  and  heat  Icterus,  conse- 
quent on  a  fit  of  anger,  with  great  excitability.  Important 
in  the  period  of  dentition ;  in  the  menstrual  period,  for 
menstrual  colic ;  metrorrhagia  with  the  characteristic  symp- 
toms of  Chamomilla — false  pains ;  in  several  varieties  of 
asthma,  with  great  sensibility.  Ischias,  cramp  of  the 
calves. 


NO.    XVI.      NUX   VOMICA. 

The  primary  action  of  Nux  Vomica  is  exerted  exclusively 
upon  the  Nervous  System,  inducing,  first,  variation  in  the 
intensity  of  action  of  that  system,  viz.,  excitation,  soon 
followed  by  torpidity,  and  secondly,  alteration  in  its  mode  of 
action. 

The  Motory  or  Centrifugal  factor  of  the  nervous  system 
is  especially  affected.  The  Central  portions  (the  ganglia 
and  the  spinal  cord  themselves)  are  more  affected  than  the 
peripheric,  and  above  all  the  abdominal  ganglia  and  those 


NO.   XVI.      NUX  VOMICA.  339 

parts  of  the  spinal  cord  in  immediate  connection  with  the 
diaphragm. 

1.  Spinal  Cord.     The  action  of  Nux  is  chiefly  on  the 
motory  or  centrifugal  factor,  producing  spasm,  especially  in 
the  abdomen  and  lower  extremities,  rather  tonic  than  clonic, 
induced  by  very  slight  exciting  causes,  even  by  change  of 
weather.     Individual  Symptoms.     Jerkings,  stiffness,  cramp, 
spasm  of  the  pharynx,  and  of  the  anus,  erection  of  the  penis, 
spasm  of  the  bladder,  in  a  word,  of  all  the  half  voluntary 
muscles,  spasmodic  distortion  of  the  face  and  mouth.     Tris- 
mus,  spasm  of  the  tongue  (followed  by  partial  paralysis)  of 
the  oesophagus  and  rectum.     All  of  these    symptoms  are 
followed  by  torpidity  and  temporary  partial  paralysis. 

2.  Vegetative   System,   Motory   Factor.      Dilatation    and 
contraction  of  the  iris,  spasm  of  the  stomach  and  intestine. 
The  chief  malady  of  this  system,  bearing  close  relation  to 
the  symptoms  of  Nux  is   cardialgia,  both   presenting   us 
eructations,  nausea,  vomiting,  constriction  and  protrusion  of 
the   intestine,    painful    anti-peristaltic    motion,    palpitation, 
pulse  momentarily  irregular. 

3.  Cerebral  System.     The  character  of  the   phenomena 
induced  by  Nux  in  this  system  is  similar  to  that  above 
depicted,  but  the  phenomena  are  less  strongly  pronounced. 
They  are  the  reflex  of  those  induced  in  the  spinal  and  vege- 
tative system.     The  Organs  of  Sense  are  strongly  influenced, 
but   those   functions   which   are   peculiarly   cerebral   (i.  e.y 
sensorial  functions,  phantasy,  etc.)  are  but  slightly  affected. 
Susceptibility  to  mental  and  sensuous  impressions  is  greatly 
increased ;  this  condition  is  soon  followed  by  one  of  apathy, 
in   which,    however,    consciousness    is   preserved.      (N.  B. 
Under  the  action  of   Stramonium  and  Hyoscyamus,  in  a 
corresponding  condition,  consciousness  is  lost.) 

4.  The  Pains  and  Sensations  excited  by  Nux  are  such  as 
usually  accompany  spasm — cramp-pains,  jerkings,  etc.     A 
feeling   of  exhaustion,    a   sensation   as   if  beaten,    is   very 
constantly  observed. 


34O  DIAGNOSIS  IN   HOMCEOPATHIC   PRACTICE. 

Phenomena  of  the  Vegetative  Life  generally. 

1.  Vascular  System.     Increased  activity,  soon  followed  by 
exhaustion,  hence  Nux  rather  retards  than  accelerates  the 
circulation    (causing   congestions).     The    general  effects  of 
Nux  in  this  respect  resemble  those  of  Cocculus  and  Ignatia. 
The  frequently  observed  phenomenon  of  external  cold  with 
internal  heat  (and  vice  versa)  is  important,  as  showing  this 
state  of  partial  excitation  and  partial  torpidity. 

Character  of  the  Fever.  Violent  chill,  external  heat  with 
internal  cold,  and  vice  versa.  The  thirst  is  slight,  or  there 
is  great  thirst  at  the  period  of  greatest  coldness  (showing 
that  the  latter  is  a  consequence  of  alteration  of  nervous 
functions,  and  not  of  an  immediate  vascular  excitement ; 
this  is  shown,  too,  by  the  fact  that  drinking  rather  aggra- 
vates than  relieves  the  thirst). 

2.  Assimilation.     The  effects  of  Nux  are  very  complex, 
its  especial  action   being   upon   the    abdominal   ganglionic 
system.     A  habitus  gastricus  is  the  chief  indication  for  its 
administration ;  a  skin  yellowish  or  earthy,  eyes  yellow  or 
dirty-looking,   tongue  coated,   teeth    yellow,  irritability    of 
temper,  hypochondriasis,  hysteria. 

3.  Gastric  Phenomena.     These  depend  on   alteration  in 
the  mode  of  action  of  the  nerves.     The  gastric  secretion  is 
modified,  the  odor  of  the  breath  is  unpleasant,  the  taste  is 
salt  or  bitter.     These  phenomena  depend  on  the  condition 
of  the  stomach,   and   not   upon    any  altered    state  of  the 
mouth  (as  appears  from  the  fact  that  the  sense  of  taste 
retains  its  full   power  of    distinguishing    different    articles 
and  qualities  of  food,  a  characteristic  of  Nux),  bulimy  or 
anorexia.     While  eating,  nausea,  headache,  tormina;  after 
eating,  these  symptoms  are  aggravated,  eructations,  vomit- 
ing, which  is  never  profuse,  but  is  generally  sour  or  bitter 
mucus.      Thirst,  yet  drinks  are  not  well  endured.     Although 
these  symptoms  occur  after  eating,  they  are  also  manifested 
at  other  times — an  evidence  of  the   alteration  of  nervous 
action. 


NO.   XVI.      NUX  VOMICA.  341 

Morning  Vomiting.  The  secretion  of  the  stomach  and 
intestines,  especially  of  the  latter,  is  diminished  in  quantity 
(hence  constipation),  as  well  as  altered  in  quality  (hence 
irritation  and  tenesmus).  Fseces  are  diminished  in  quantity, 
hard,  dark,  and  compact. 

Hepatic  System.  On  this  system  Nux  acts  powerfully. 
Its  effects  are  rather  dynamic  than  organic.  The  secretion 
of  bile  is  markedly  increased. 

Genital  System.  Erethism,  manifested  by  pollution,  and 
too  rapid  emission  ;  or  again,  as  the  result  of  over-excite- 
ment, by  loss  of  erectile  power.  Menstruation  too  early  and 
too  copious. 

Respiratory  System.  Spasmodic  action.  The  secretion 
of  the  mucous  membranes  is  diminished  ;  they  are  irritable, 
hence  a  cough  is  easily  produced  ;  a  dry,  tickling  cough, 
with  scanty,  thick,  tenacious  expectoration.  A  frequent 
sensation  of  constriction,  arising  partly  from  spasm,  and 
partly  from  congestion. 

Characteristics.  I.  High  excitement  of  the  whole  nervous 
system,  especially,  however,  of  those  parts  of  the  spinal  and 
ganglionic  system  which  lie  below  the  diaphragm  ;  especial 
relation  to  the  motory  sphere  ;  hence  spasm,  both  tonic  and 
clonic. 

2.  Vascular  System.     Excitation  and  impediment,    each 
of  these  phenomena  having  the  character  of  partiality. 

3.  Powerful  effects  upon  the  vegetation,  especially  in  the 
digestive  canal ;  hence  gastric  affections  predominate.     In 
general,  diminished  secretions  (hence  constipation)  ;  irrita- 
tion of  the   thoracic  organs ;    sexual   erethism ;    too  early 
menstruation.    Seldom  pain,  with  the  exception  of  headache ; 
rather,  sensations  are  produced. 

Administration.  Nux  is  especially  appropriate  to  diseases 
of  men,  lean,  of  strong  fiber,  who  take  rich  food,  are  given 
to  spirituous  drink,  and  to  mental  labor ;  in  following  dis- 
eased conditions. 

I.  Nervous  Affections.    Spasm.,  general  or  partial,  especially 


342  DIAGNOSIS  IN   HOMOEOPATHIC   PRACTICE. 

of  the  lower  part  of  the  body, — especially  those  which  involve, 
at  the  same  time,  the  muscles  of  both  the  animal  and  vege- 
tative spheres;  in  all  cases  where  Nux  is  indicated,  conscious- 
ness must  be  retained;  cases  in  which  pressure  or  warmth 
applied  to  the  vertebral  column  provokes  the  spasms.  Tonic 
spasm,  in  the  forms  of  tetanus,  trismus,  eclampsia  infantum, 
etc.  Nux  is  a  very  important  remedy  in  cases  of  trembling 
induced  by  metallic  poisoning,1  and  in  saturnine  colic. 
Spasms  of  the  pharynx  and  larynx,  and  of  the  diaphragm  ; 
angina  pectoris.  Spasm  of  the  stomach;  spasmodic  vom- 
iting, with  scanty  evacuation ;  vomiting  during  pregnancy. 
Hernia.  Flatulent  and  menstrual  colic. 

Over-excitability  of  the  senses.  Irritation  of  the  spinal  cord. 

2.  Intermittent  Fever.     Nux  is  probably  indicated  in  nine 
cases  out  of  every  ten.2   These  cases  are  distinguished  by  cer- 
tain gastric  phenomena  ;  the  complexion  is  of  a  light  icteric 
hue ;    there  is  obstinate  constipation,  with  violent  pain  in 
the  loins.     The  cold  predominates.     Thirst  is  present,  yet 
drinking  aggravates  the  symptoms. 

3.  In    Typhus,   Nux   is   only   sympathetically   indicated, 
when  there  is  continued  constipation,  or  in  the  mild  form 
of  typhus,  attended  by  the  peculiar  gastric  symptoms  of 
Nux. 

4.  Sub-acute  and  chronic  muscular  rheumatism;  certain 
forms  of  delirium  tremens  ;  nervous  vertigo,  depending  on 
abnormal   affections.     Morning   vomitus    after   a   debauch. 
Headache  after  meals ;  the  cephalic  congestion  always,  if 
conjoined  with  gastric  phenomena. 

5.  In  gastric  derangements  from  use  of  coffee  ;  dynamic 
affections  of  the  liver.    In  hernia,  both  free  and  incarcerated. 
In  haemorrhoids.     In  neuralgia.    In  catarrh,  with  dry,  labo- 
rious, tickling  cough  ;  with  spasm,  and  even  vomiting. 

1  For  poisoning   by  Arsenic,  with          *  It  will  be  remembered  that  these 

trembling  of  the  hands,  in  hat-makers,  lectures  were  delivered  in   a  suburb 

they   give,  in   the   General   Hospital  of  Vienna,  in  which  a  peculiar  form 

(Allopathic)   of   Vienna,  sulphur,  in  of  Intermittent  Fever  is  endemic. — 

drachm  doses,  and  relieve  the  patient  C.  D. 
generally  in  about  four  days.—  C.  D. 


BELLADONNA.1 


Belladonna  excites  simultaneously  the  nervous  and  vas- 
cular systems,  and  is  hence  indicated  neither  in  pure  inflam- 
matory fever,  nor  in  pure  nervous  fever,  but  as  a  kind  of 
amphibious  remedy  in  that  condition  in  which  the  symptoms 
of  both  appear, — in  the  "  neurophlogosen  "  of  Schonlein,  in 
the  "febris  inflammatoria  nervosa"  of  Vogt, — hence  not  in 
pure  phlegmonous  inflammation  nor  in  pure  spasm  but  in 
inflammatory  spasm. 

I.  VASCULAR  SYSTEM.     Strongly  excited;  most  of  all  the 
capillary  system,   in  which   the   effects  of  Belladonna   are 
especially  manifest  in  the  skin,  throat,  head  and  lungs,  con- 
stituting an  affection  very  similar  to  scarlatina.     (According 
to  Schonlein,  the  scarlatina  pulse  is  present.)     Belladonna  is 
the  Aconite  of  the  capillary  vascular  system. 

II.  VEGETATION.      Skin   and   mucous    membranes,   are 
attacked ;   hence,  dryness    of  the   throat   and   constriction, 
increased  thirst,  diminished  secretions,  burning  and  spasms 
of  the  stomach. 

III.  Although  Belladonna  affects  powerfully  the  GLAND- 
ULAR SYSTEM,  yet  it  gives  no  especial  characteristic  indi- 
cation. 

IV.  NERVOUS  SYSTEM.   Exaltation,  alienation,  and  depres- 
sion, the  last  only  from  large  doses   (bad  provings),  and 
affording  no  special  indication.     This  affection  of  the  nervous 
system  depends  not  only  upon  the  encephalon  but  also  upon 
the  spinal  cord;    and  the  sensitive   as  well  as  the  motor 
nerves   are   affected;   hence   pains,   convulsions,   and  tonic 

1  Report  of  a  Clinical  Lecture  by  Dr.  Wurmb,  in  the  Second 
Homoeopathic  Hospital,  Vienna. 


344  BELLADONNA. 

spasms,  are  first  induced,  and  finally  paralysis.  Upon  the 
ganglionic  system  Belladonna  acts  as  a  depressing  agent. 

Characteristics.  I.  Pain.  Oppression,  pressing  from 
within  outward  and  vice  versa,  also  throbbing.  The  pain 
conies  on  suddenly,  rises  quickly  to  its  greatest  intensity, 
and  suddenly  vanishes  or  changes  its  seat.  It  is  aggravated 
in  the  evening  and  at  night  by  coffee,  wine,  vinegar  (hence 
vinegar  is  no  antidote) ;  ameliorated  by  pressure  and  com- 
pression. 

Indications.  I.  Inflammation  of  the  ear,  erysipelatous ; 
ditto  of  the  throat  and  fauces  with  constriction,  which  serves 
to  distinguish  Belladonna  from  Mercurius  and  from  Nitric 
Acid,  which  last  is  indicated  where  aphthae  appear  on  the 
tonsils.  Also  in  malignant  angina. 

2.  In  pneumonia,  typhus,  and  acute  catarrh,  with  cerebral 
complications.     Tussis  convulsiva  more  frequently  requires 
other  remedies,   as    Hyoscyamus,   Sulphur,   Veratrum    and 
Cuprum. 

3.  Abdominal  affections.      Flatulent    colic,    sausage-like 
inflation  of  the   colon  with  pain   in    the    umbilical    region. 
Hernia,    in   inflammatory   condition.       Hepatic    congestion. 
Icterus  inflammatorius.      Haemorrhoids  with  constriction   of 
the  sphincter. 

4.  Nervous  affections.     Melancholy  during  pregnancy  and 
the  puerperal  state.     Spasm  with  consciousness  (peculiar  to 
Belladonna).       Mania.      Delirium    tremens.      Hydrophobia 
(Wurmb  has  no  experience ;  would  incline  to  expect  more 
from  the  animal  poisons). 

5.  Nervous  accidents.      I.  Clonic  spasms  in  the  upper  part 
of  the  body.     Epilepsy.     Chorea  (with  reference  always  to 
\htgenius  of  the  remedy),     i.   Congestio  ad  caput.     Dis- 
turbed menstruation.     Raphania.     2.   Pain.     a.  Prosopalgia 
Fothergillii   (also   Ferrum   Carbonicum)  in  cases  in  which 
there    is    simultaneous     vascular    excitement.       In    purely 
nervous   cases   it   is    not   indicated.      (Spigelia   preferable.) 
b.  Toothache  ;  gums  inflamed  ;  aggravated  by  cold.    c.  Sleep- 


BELLADONNA.  345 

lessness,  especially  of  plethoric  children.  From  nervous 
over-excitement.  (Coffea.)  d.  Certain  particular  nervous 
maladies.  I.  Febris  nervosa  versatilis  of  the  ancients,  or 
typhus  in  which  the  abdominal  ulcers  are  wanting;  2. 
Typhus  cerebralis  ;  3.  Febris  intermittens  apoplectica. 

6.  Vascular  diseases.    I.  Congestion.    Pain  in  sinciput;  great 
sensibility  to  air  and  noise  ;  roaring  in  the  head,  sparks  before 
the  eyes,  especially  in  amenorrhoea  and  dysmenorrhcea ;  apo- 
plexy and  its  prodromena.     In  short,  in  every  case  in  which 
the  allopath  would  resort  to  venesection.     An  antidote  to 
Hyoscyamus.     2.  Inflammation,     a.  Of  the  brain  and  mem- 
branes, especially  in   metastasis   from    scarlatina;    delirium 
ferox,  dilated  pupils,  red  face,  spasms.     In  children  during 
dentition  (when  the  irritation  is  too  great  for  Chamomilla) ; 
when  tonic  spasms  occur  (compare  Hyoscyamus  and  Stra- 
monium).    The  large  cerebrum  of  children  disposes  them  to 
this  affection ;  hence  Belladonna  is  appropriate  as  prophy- 
lactic,    b.    Ophthalmia.      I.    Scrofulous    ophthalmia,    as  an 
intercurrent  remedy  in  case  of  photophobia  with  vascular 
injection  (without  this,  Conium)  and  dryness  of  the  eyes. 

2.  Catarrhal  ophthalmia,  with  dryness  of  throat  and  cough. 

3.  Arthritic  ophthalmia.     4.  Internal  ophthalmia,  amblyopia 
and  recent  amaurosis. 

7.  Sexual  diseases.     Metrophlebitis  even  in  metastasis  to 
the  parotid,  the  joints,  etc.     Mania  puerperalis.     Orgasm  to 
the  uterus.      Menses  copious,  black,   clotted.     A  pressing 
outward.     Cutting  lumbar  pains  extending  round  to  hypo- 
gastrium.      Sensibility    of   the    uterus.       Affections  before 
and  after  menstruation.      Labor-pains  deficient  from  non- 
dilatation  (rigidity)  of  the  os  uteri. 

8.  Skin.    i.  Scarlatina, — the  smooth  variety,  not  the  mili- 
ary.    In  ordinary  scarlatina  Aconite  and  Belladonna  alter- 
nately.    Also  the  same  as  prophylactics.     Wurmb  always 
succeeds  giving  them   in   small  doses  (30)  one  remedy  each 
day  in  a  single  dose.     Measles  with  affection   of   the  head 
and  throat.     Erysipelas,  smooth  form   (the  vesicular,  Rhus). 


346  BELLADONNA. 

External  erysipelatous  inflammation  of  the  ears.  2.  Glands. 
Inflammation  of  the  salivary  glands  with  affection  of  the 
head.  For  the  inguinal  glands  and  testes  slight  affinity. 
Inflammation  of  axillary  glands  during  the  climacteric 
period,  and  when  the  swelling  remains  stationary  and 
resembles  scirrhus  and  is  worse  during  menstruation.  Degen- 
eration of  the  mamma,  and  erysipelatoid  inflammation,  but 
not  traumatic  inflammation,  in  which  Arnica  in  small  doses  is 
indicated.  Inflammation  of  the  uterus  with  great  haemor- 
rhage, pressing  outward. 


A  WEAK  SPOT  IN  OUR  MATERIA  MEDICA. 


The  Homoeopathic  Materia  Medica  is  constructed  upon 
the  results  of  provings  on  healthy  subjects.  Every  day's 
experience,  in  its  application  at  the  bedside,  shows  us  that 
the  more  accurate  the  prover's  observation  of  the  symptoms 
which  the  drug  produces  in  him,  the  more  certainly  can  we 
determine  whether  the  drug  is  appropriate  for  our  case. 

We  call  certain  drugs  "well  proved"  because  the  state- 
ments of  symptoms  are  so  clear,  the  discriminations,  especially 
of  subjective  symptoms,  are  so  sharp  and  well  defined,  as 
regards  character,  locality,  direction  and  conditions,  that  we 
get,  by  study  of  the  proving,  a  vivid  realization  of  the  patho- 
genesis,  and  can  be  sure  whether  a  similarity  exists  between 
it  and  our  patient's  array  of  symptoms.  And,  moreover,  the 
symptomatology  of  some  of  our  "well  proved"  drugs  is  so 
full  and  precise  that  we  are  able,  particularly  if  we  borrow  a 
little  from  the  toxicologist,  to  construct  a  very  complete 
pathological  theory  of  the  drug-action,  with  which  we  may 
compare  our  theory  of  the  pathology  of  the  patient's  disease  ; 
and  thus  we  may  have  the  double  satisfaction  of  a  patho- 
logical and  a  symptomatological  correspondence  between 
patient  and  drug. 

A  reference  to  our  Materia  Medica,  in  so  far  as  the  symp- 
toms of  the  respiratory  organs  are  concerned,  will  illustrate 
this  point.  How  sharply  defined,  for  example,  are  the  indi- 
cations for  Aconite,  Bryonia,  Squilla,  Phosphorus,  Sulphur, 
Chelidonium,  Antimonium  tartaricum,  Spongia,  Veratrum, 
Bromine,  and  many  other  drugs!  In  other  words,  how 
clearly  do  the  symptoms  reveal  to  us  what  part  of  the 
apparatus  is  affected,  and  how  it  is  affected,  down  to  the 


348          A  WEAK  SPOT  IN  OUR   MATERIA   MEDICA. 

finest  shades  of  difference  !  And  with  what  remarkable 
precision  and  certainty,  as  compared  with  former  medical 
experience,  are  we  enabled  to  prescribe  in  affections  of  the 
respiratory  organs  ! 

A  strong  contrast  with  this  precision  and  certainty  is 
presented  by  the  indefinite  indications  we  possess  for  pre- 
scriptions in  diseases  of  the  sexual  organs  of  women.  Even 
our  "  best  proved  "  drugs  furnish  comparatively  few  symp- 
toms referable  to  these  organs ;  and,  of  these  few,  the 
language  is  generally  so  vague  that  we  are  at  a  loss  to 
determine  what  part  of  the  apparatus  may  have  been  the 
seat  of  the  sensation  described.  Even  the  descriptions  of 
objective  symptoms  are  often  most  unsatisfactory  and  indef- 
inite. Compare,  in  evidence  of  this,  the  relative  clearness 
and  fullness  with  which  discharges,  for  instance,  from  the 
respiratory,  and  from  the  female  sexual  organs  have  been 
described  by  provers. 

Here,  then,  is  a  weak  spot  in  our  Materia  Medica ;  and, 
practically,  it  is  one  that  we  must  greatly  deplore.  Women's 
diseases  constitute  a  large  majority  of  our  cases.  For,  at 
least  half  of  the  community  are  women  ;  and,  what  with  the 
enforced  illnesses  contingent  on  maternity;  upon  evolution 
and  involution,  which  are  often  attended  with  serious  dis- 
eases ;  because  of  our  modes  of  living,  which  bear  so  hardly 
upon  woman ;  upon  the  unequal  struggle  which,  as  yet, 
women  are  forced  to  maintain,  who  wage  alone  the  hard 
battle  of  life, — this  half  of  the  community,  as  the  records  of 
all  of  us  must  show,  call  for  professional  aid  at  least  twice  as 
often  as  the  other.  And  yet,  in  reference  to  their  peculiar 
diseases,  our  Materia  Medica  is  weakest. 

The  reason  and  the  remedy  are  not  far  to  seek. 

We  have  comparatively  few  symptoms  of  drug-action 
upon  women,  because  comparatively  few  women  have  been 
provers  of  drugs.  And  the  symptoms  we  have  are  lacking 
in  precision,  because  our  women-provers,  as  a  rule,  have 
been  deficient  in  definite  knowledge  of  the  structure  and 


A  WEAK   SPOT  IN   OUR   MATERIA   MEDICA.  349 

physiology  of  the  organs  distinctive  of  their  sex,  and  have, 
therefore,  been,  to  some  extent,  incompetent  observers. 
They  have  often  better  described  the  symptoms  of  the 
respiratory  organs  which  they  possess  in  common  with  men, 
than  of  their  own  characteristic  sexual  organs ;  a  fact  not 
surprising,  perhaps,  but  certainly,  from  the  stand-point  of 
the  Materia  Medica,  deplorable. 

This  want  in  our  Materia  Medica  can  be  supplied  only  by 
the  voluntary  labors  of  women  as  provers  of  drugs.  And 
that  their  provings  may  possess  the  requisite  definiteness  and 
precision,  the  provers  must  have  acquired  such  a  degree,  at 
least,  of  professional  knowledge  as  to  understand  the  anatomy, 
physiology  and  relations  of  the  apparatus  peculiar  to  their 
sex.  In  other  words,  they  must  be,  for  this  object,  at  least, 
and  to  this  extent,  physicians.  More  especially  is  this  neces- 
sary as  regards  the  symptoms  produced  upon  the  sexual 
apparatus  of  women,  since,  in  the  work  of  defining  and  com- 
prehending these  symptoms,  at  least,  they  can  receive  no  aid 
from  professional  men. 

None  but  women  can  do  this  work.  None  but  women 
educated  in  medical  science  can  do  it  worthily  and  well,  so 
that  our  Materia  Medica  may  be  an  efficient  means  for 
the  treatment  of  women's  diseases.  If  this  fact  furnish  an 
argument  for  the  medical  education  of  women,  the  fault 
lies  in  nature !  And  if,  engaged  in  the  execution  of  such 
a  work  as  is  here  indicated, — so  sorely  needed,  and  which 
they  alone  can  perform, — women  physicians  should  seek 
admission  to  the  privileges  of  our  profession,  I,  for  one, 
could  not  imagine  a  more  complete,  nor  a  more  beneficent 
vindication  of  their  right,  than  such  a  contribution  to  human 
knowledge  would  be. 


DIRECTIONS   FOR  DRUG-PROVERS, 
GIVEN  TO  THE  WOMEN  WHO  PROVED  LILIUM  TIGRINUM. 


The  object  in  proving  a  drug  is  to  ascertain  the  changes 
which  the  drug  is  capable  of  producing  in  the  functions  and 
organs  of  the  healthy  body. 

It  is  very  important  that  each  prover  should  know  and 
be  able  to  recognize  the  various  sensations  and  variations 
of  function  to  which  she  may,  by  peculiarity  of  consti- 
tution, be  subject  when  in  average  health  ;  so  that  she  may 
not,  while  proving  a  drug,  mistake  such  natural  variations 
for  effects  of  a  drug. 

The  prover  should  have  at  hand,  at  all  times,  a  note- 
book, in  which  to  record  the  times  of  taking  the  drug  and 
the  doses,  as  well  as  the  symptoms  as  they  occur.  The 
record  should  be  made  as  soon  as  the  .  symptom  is  per- 
ceived, and  the  time  of  its  occurrence  and  the  circumstances 
of  the  prover  at  the  time  should  be  recorded. 

Before  beginning  the  record  of  a  proving,  the  prover 
should  inscribe  in  the  note-book  a  statement  of  her  age, 
temperament,  the  sicknesses  which  she  has  had,  and  those 
to  which  she  has  an  inherited  or  acquired  tendency ;  also 
whatever  pains  or  sensations  she  may  be  habitually  subject 
to  ;  also  any  peculiar  susceptibilities  she  may  possess  to 
external  influences  of  any  kind,  or  to  mental  or  moral  or 
emotional  excitements,  depressions,  or  perversions.  Her 
constitutional  peculiarities  respecting  the  menstrual  function 
should  be  carefully  recorded  ;  regarding  frequency,  quantity, 
character,  and  whatever  inconveniences  or  sufferings  pre- 
cede, accompany,  or  follow  menstruation ;  such  as  headache, 


DIRECTIONS  FOR  DRUG-PROVERS.  351 

backache,  colic,  leucorrhcea,  etc.,  together  with  peculiar 
states  of  mind  or  emotion. 

In  describing  sensations  or  pains  which  may  occur  during 
a  proving,  it  is  not  sufficiently  definite  to  say  "  pain  in  the 
head,"  "  pain  in  the  back,"  etc.  The  character  and  locality 
of  the  pain  must  be  exactly  described  in  graphic  language, 
— stating,  for  example,  that  the  pain  is  "cutting,"  "burning," 
"  sticking,"  etc., —  and  specifying  its  location,  and,  if  it  move, 
its  course. 

The  prover  should  find  out  by  experiment,  and  should 
carefully  state,  what  circumstances  aggravate  or  ameliorate 
the  pain  (or  other  symptom),  and  note  its  periodical  recur- 
rence, because  periodicity  is  a  very  important  element  in 
the  history  of  the  action  of  drugs.  For  example :  is  the 
pain  worse  when  the  prover  stands,  or  sits  or  lies  down, 
worse  during  exercise  and  better  during  rest,  worse  on  first 
waking,  worse  in  the  cold  and  relieved  by  heat,  worse  or 
better  from  touch  or  pressure,  etc.,  etc.  All  such  condi- 
tions of  aggravation  or  amelioration  should  be  carefully 
recorded. 

If  the  pain  move  from  one  part  of  the  body  to  another, 
the  fact  and  the  course  of  the  pain  should  be  recorded. 

The  sides  of  the  body  on  which  symptoms  occur  should 
always  be  stated. 

The  times  of  occurrence,  aggravation,  and  amelioration 
are  very  important  elements ;  as,  in  the  morning  or  after- 
noon ;  at  night,  before  or  after  midnight,  or  waking  from 
sleep  ;  just  before  or  after  eating,  etc.,  etc. 

Changes  in  the  quantity,  quality,  and  appearance  of  the 
natural  secretions  should  be  carefully  described.  The 
urine,  for  instance,  should  be  measured,  and  the  quantity 
per  day  recorded  ;  it  should  be  tested  for  acid  and  albu- 
men, and  whatever  sediment  it  may  deposit  should  be 
carefully  described.  Modifications  of  the  menstrual  func- 
tions should  be  most  carefully  recorded ;  such  as  its  greater 
or  less  frequency  or  quantity  ;  alterations  of  color  and  con- 


352  DIRECTIONS   FOR   DRUG-PROVERS. 

sistency ;  whether  acrid  or  not ;  pains  and  discomforts  of 
body  or  mind  which  precede,  accompany,  or  follow  it. 

Secretions  not  observed  by  the  prover  when  in  health — 
such  as  leucorrhcea,  unusual  perspirations,  etc. — should  be 
described,  as  to  color,  consistency,  odor,  nature ;  whether 
bland  or  acrid,  times  of  occurrence,  and  circumstances  which 
increase  or  diminish  them,  and  symptoms  which  accompany 
them. 

If  organic  symptoms  occur,  such  as  eruptions  or  sus- 
pected enlargements  or  displacements  of  organs,  it  is  well 
to  consult  a  physician  in  order  to  ascertain  the  exact  condi- 
tion, which  should  be  carefully  described. 

The  records  should  be  full  and  minute.  It  is  better  to 
be  obliged  to  erase  something  afterward,  than  to  risk  the 
loss  of  an  important  symptom  by  aiming  at  brevity. 

The  dose  should  be  taken  at  a  time  when  the  prover  can 
rest,  in  mind  and  body,  for  a  half  hour  after  taking  it. 
The  early  morning  is  the  best  time,  for  then  the  prover 
will  have  a  chance  to  observe  the  action  of  the  drug  for 
fifteen  to  eighteen  hours  without  interruption  by  sleep.  It 
is  better  to  begin  with  a  small  dose,  gradually  increasing  it 
until  effects  are  recognized,  and  then  to  cease  taking  the 
drug  until  these  effects  have  ceased.  It  may  then  be 
repeated  in  a  somewhat  larger  dose.  No  danger  of  per- 
manent illness  is  incurred  by  this  mode  of  proving  drugs. 

During  a  proving,  the  prover  should  abstain  from  the 
use  of  medicines,  cosmetics  and  perfumes,  but  should  make 
no  marked  deviation  from  her  usual  diet  and  regimen. 
Habits  of  so  long  standing  as  to  have  become  "  second 
nature  "  should  be  continued  in  moderation,  since  to  break 
them  off  suddenly  is  to  institute  at  once  a  morbid  state. 


LILIUM  TIGRINUM. 

A  SUMMARY  OF  A  FEW  PROVINGS   UPON  WOMEN. 

My  studies  have,  for  years  past,  shown  me  the  weakness 
of  the  Homoeopathic  Materia  Medica  in  respect  of  the  physi- 
ological effects  of  drugs  upon  the  peculiar  organism  of 
women.  This  is  due  to  the  fact  that  but  few  of  the  provers 
to  whose  observation  we  owe  our  Materia  Medica  were 
women.  I  have  not  been  able  to  imagine  any  method  by 
which  this  deficiency  in  the  Materia  Medica  could  be  sup- 
plied, except  by  the  voluntary  acts  of  women,  who  should 
undertake  to  prove  drugs.  And  it  has  seemed  to  me 
improbable  that  this  work  could  be  performed  with  the 
requisite  accuracy  and  intelligence  unless  the  women  who 
should  undertake  it  were  educated  in  the  medical  sciences. 
Finally,  it  appeared  to  me  that  women  who  had  become  by 
education  and  acquirements  members  of  the  medical  pro- 
fession, would  not  be  likely  to  take  a  hearty  and  efficient 
part  with  us  in  the  great  work  of  perfecting  the  vital 
element  of  our  science, — the  Materia  Medica, — unless  they 
were  recognized  and  received  by  us  as  fellow-workers  on  an 
equal  footing  in  every  respect,  for  a  similar  reason  to  that 
which  led  Mr.  Dickens  to  decline  the  Queen's  invitation  to 
give  a  reading  at  Windsor  Castle,  saying,  "  I  will  not  appear 
as  an  artist  where  I  should  not  be  received  as  a  man ; " 
and,  conversely,  I  thought  that  if  so  received  they  would 
respond  cordially  and  generously  to  an  invitation  to  engage 
in  the  work  for  the  promotion  of  medical  science,  and  in  a 
department  in  which  they  alone  could  work,  and  the  com- 
pleteness of  which  would  be  forever  a  monument  of  their 
ability  and  devotion. 
24 


354  LILIUM   TIGRINUM. 

When,  therefore,  at  the  session  of  the  Institute  in  1 869  a 
resolution  was  pending  which  declared  the  eligibility  of 
properly  qualified  women  to  membership,  I  determined  to 
invite  women  who  had  joined  the  medical  profession  to 
engage  in  the  labor  of  proving  drugs,  feeling  confident  that 
the  results  of  their  work  would  demonstrate  how  valuable 
and  indispensable  it  is  to  the  completion  and  perfection  of 
our  Materia  Medica.  The  results  even  thus  far  have  justi- 
fied this  confidence.  More  than  thirty  women,  most  of 
them  members  of  the  profession,  responded  cordially  to  my 
invitation,  and  entered  upon  the  work  of  drug-proving. 
One-third  of  the  number  have  already  reported  results  of  a 
satisfactory  nature,  and  of  which  I  here  present  a  sum- 
mary. 

The  drug  selected  for  proving  was  the  Lilium  tigrinum — 
the  tiger-lily  —  which  was  introduced  into  the  Materia 
Medica  by  Dr.  W.  E.  Payne,  of  Bath,  Me.,  who  had 
communicated  to  us  just  enough  to  show  that  it  had  a 
powerful  specific  action  upon  the  female  organism.  The 
symptoms  were  known,  however,  only  to  members  of  the 
Institute.  I  thought  that  by  engaging  a  number  of  provers 
in  different  parts  of  the  country,  in  a  simultaneous  proving 
of  this  drug,  utterly  unknown  to  most,  if  not  all  of  them,  I 
should  receive  reports  which,  if  they  should  corroborate  each 
other,  would  be  very  conclusive  as  to  the  action  of  the  drug. 

Inasmuch  as  this  drug  belongs  by  right  of  discovery  to 
Dr.  W.  E.  Payne,  I  have  turned  over  to  him  the  verbatim 
reports  received  from  my  provers,  that  he  might  incorporate 
them  with  his  own,  and  prepare  the  whole  for  publication  in 
the  Transactions  of  the  Institute. 

The  first  proving,  and  which  I  shall  give  in  greatest 
detail,  was  made  under  my  own  observation  and  direction, 
by  a  lady  of  30  years,  unmarried,  a  practicing  physician, 
and  who  had  always  enjoyed  good  health,  although  quite 
susceptible  to  the  action  of  drugs. 

No.  i.     She  began  her  proving  Oct.  I,  1869,  by  taking 


LILIUM   TIGRINUM.  355 

three  drops  of  the  ^  centesimal  dilution  of  Lilium  tigrinum 
thrice  daily.  She  reports  as  follows : 

"  I  first  noticed  that  I  was  more  active ;  things  went 
easily.  There  was  no  other  effect  for  four  days,  unless  it 
was  increased  sexual  instinct ;  then  a  sweetish  nausea,  with 
fullness  of  the  abdomen,  particularly  after  eating — even  after 
eating  small  quantities.  But  food  does  not  increase  the 
nausea  ;  no  desire  to  vomit. 

"  On  the  6th  day  moral  symptoms  were  developed.  I  do 
not  want  to  be  pleased ;  don't  care  to  talk ;  desire  to  sleep. 
Slept  well  all  night,  with  unpleasant  dreams.  Omitted 
medicine  two  days,  during  whicli  the  nausea  and  full  feeling 
subsided.  At  intervals  the  skin  of  the  abdomen  felt  stiff 
and  stretched.  On  the  7th  day  took  five  drops  of  the  3°, 
and  in  a  few  hours  the  nausea  was  much  increased, 
with  the  same  bloated  sensation  in  the  abdomen,  par- 
ticularly across  the  hips  and  in  the  region  of  the  uterus; 
darting  pains  in  different  parts  of  the  head,  some  tearing 
pain  in  the  lower  part  of  the  abdomen  from  the  region  of 
the  ovary  down  both  sides.  I  ate  as  much  as  usual,  but 
felt  no  appetite  for  it;  was  restless,  with  a  desire  to  do 
something,  but  no  ambition.  A  sensation  of  pressure  in 
the  vagina,  and  a  pain  at  the  top  of  the  sacrum  extending 
to  the  hips. 

"  8th  Day.  Worse  on  going  to  bed ;  can't  go  to  sleep ; 
wild  feeling  in  the  head,  as  though  I  should  go  crazy  and 
no  one  would  take  care  of  me ;  thoughts  of  suicide ;  how 
much  opium  would  put  me  to  sleep  forever,  and  who 
would  find  my  body,  and  who  would  care ;  nausea  constant. 

"  loth  Day.  Pain  in  the  right  iliac  region,  better  during 
motion ;  the  head  grows  wild  after  I  have  been  quiet  for  a 
short  time.  At  2  P.  M.  of  the  loth  day  (Oct.  10),  took  five 
drops  of  the  3°.  Increased  depressing  weight  over  the 
pubes;  worse  in  the  evening.  The  knees  ache."  No  more 
medicine  was  taken  by  this  prover. 

Eight  days  afterward  (Oct.  2Oth),  she  came  to  me  to  state 


356  LILIUM  TIGRINUM. 

her  symptoms,  her  mind  being  in  such  a  state  that  she  could 
not  herself  record  them.  The  following  symptoms  had 
come  on  on  the  2Oth  (ten  days  after  last  dose),  and  steadily 
increased :  A  sensation  in  the  pelvis  as  though  everything 
was  coming  into  the  world  through  the  vagina.  Last  night 
it  was  very  distressing,  and  not  relieved  by  change  of 
position.  The  dragging  downward  toward  the  pelvis  is  felt 
as  high  as  the  stomach  and  even  the  shoulders ;  not  relieved 
by  lying  down,  though  worse  when  standing ;  a  disposition  to 
place  the  hand  upon  the  hypogastrium  and  press  upward  in 
order  to  relieve  the  dragging  sensation.  Likewise  an  aching 
and  pressure  across  the  lumbo-sacral  region,  and  some 
pressure  upon  the  rectum.  Likewise  pressure  and  a  crazy 
feeling  upon  the  vertex,  so  that  she  cannot  write  her 
symptoms.  To-day  (22d),  when  walking,  a  sensation  as  if 
everything  were  pressing  down  in  the  pelvis  and  into  the 
vagina,  so  that  she  inhales  forcibly  in  order  to  draw  up  the 
thorax  and  clear  the  pelvis. 

She  wants  somebody  to  talk  to  her  and  entertain  her. 
Feels  quite  nervous ;  wants  to  cry  from  a  feeling  of  irritation 
and  of  something  wrong  in  the  abdomen  and  pelvis.  Feels 
hurried  and  yet  incapable,  as  if  she  had  a  great  deal  to  do 
and  cannot  do  it ;  much  thirst ;  drinks  often,  and  much  at  a 
time. 

Bowels  generally  regular.  Now  she  has  alternately  a  solid 
and  a  loose  stool,  several  during  the  day,  and  a  constant 
feeling  as  though  she  must  have  a  stool ;  this  feeling  result- 
ing from  a  sensation  as  if  something  were  pressing  against 
the  anterior  wall  of  the  rectum  at  the  anus  and  about  one 
to  three  inches  above  it. 

She  is  conscious  of  feeling  nervous  and  irritable,  and  yet 
says  she  feels  jolly.  Grumbling  pain  in  right  side  of  head 
and  teeth. 

Yesterday,  when  walking,  pain  in  both  ovaries,  worse  in 
the  left,  extending  down  the  anterior  and  inner  aspect  of  the 
left  thigh,  as  if  it  would  be  impossible  to  take  another  step ; 


LILIUM  TIGRINUM.  357 

as  soon  as  she  extended  the  limb  she  must  immediatly  flex 
it  again,  and  then,  because  of  a  restless  discomfort,  must 
again  extend  it  At  length  she  went  to  sleep  on  the  back 
with  knees  and  thighs  flexed. 

She  cannot  tell  which  pelvic  pain  is  the  worse,  that  in  the 
back  or  that  in  the  pubic  region.  The  whole  contents  of 
the  pelvis  seem  to  drag  downward  and  forward  and  quite 
from  the  epigastric  region. 

She  cannot  record  her  symptoms.  Don't  want  to  com- 
plain, and  yet  don't  avoid  people.  Feels  bloated,  but  is  not 
so.  Somewhat  tender  on  pressure  in  the  region  of  the 
ovaries,  especially  the  right. 

Oct.  23.  Aching  in  the  pelvis  between  promontory  of 
sacrum  and  the*,  pubes.  It  feels  to  her  as  if  the  aching  were 
not  in  the  uterus  but  around  it.  She  feels  constantly  the 
two  spots  corresponding  to  the  ovaries,  and  which  ache  and 
feel  like  little  coals  of  fire.  In  the  pelvis,  a  feeling  like  a 
dragging  out,  as  if  the  whole  contents  were  pushing  down 
into  a  funnel,  the  outlet  of  which  coincided  with  the 
vagina. 

Oct.  25.  For  the  last  36  hours  constant  desire  for  stool 
from  pressure  on  the  rectum  ;  a  stool  every  half  hour,  lumpy, 
diarrhceic,  with  flatus ;  constant  tenesmus,  and  burning  in 
the  urethra.  These  symptoms  continued,  along  with  those 
before  described,  for  several  days.  The  pain  in  the  right 
ovary  increased,  until  on  the  i6th  she  described  it  as  if  a 
knife  were  inserted  into  the  ovary  and  ripped  down  the  groin 
and  the  anterior  part  of  the  thigh  ;  the  pain  extended  over 
the  lumbo-sacral  region,  and  she  must  cry  herself  to 
sleep.  Somewhat  relieved  by  pressure  on  the  ovarian 
region. 

Diarrhoea  and  pressure  on  bladder  continue  without  relief 
until  the  2/th.  She  remarks  that  her  symptoms  are  all 
worse  when  she  gives  up  active  resistance  to  them  and  con- 
trol over  herself,  as  for  example,  when  she  sits  down  to  rest 
or  tries  to  go  to  sleep. 


358  LILIUM   TIGRINUM. 

Oct.  28.  Menses  occurred  at  the  regular  day  and  normal, 
but  only  while  she  keeps  moving.  The  flow  ceases  when 
she  becomes  quiet.  She  feels  much  hurried  and  driven,  but 
knows  not  why;  walks  fast  and  constantly,  but  aimlessly; 
is  much  confused  in  mind. 

Oct.  29.  She  noticed  some  heart  symptoms,  not  very 
definite.  On  the  3Oth,  after  walking,  a  sudden  fluttering 
sensation  in  the  heart.  This,  like  all  other  symptoms,  is  less 
felt  if  she  can  busy  herself  much.  A  hurried  feeling  about 
the  heart  with  faintness  and  fluttering  as  though  she  could 
make  no  exertion  but  must  sit  still.  The  seat  of  pain  is  the 
apex  of  the  heart.  Twice  she  had  a  sharp  pain  there.  Feels 
hurried  as  though  she  must  breathe  quickly,  yet  does  not. 

The  prover  feels  that  her  whole  system  has  been  pro- 
foundly affected  by  the  drug.  "  She  is  not  the  person  she 
once  was ; "  feels  hurried  but  incapable ;  no  heart  nor 
strength  for  business ;  discouraged  and  despondent. 

Nov.  i.  A  dry,  single  cough ;  heart  symptoms  very 
troublesome  ;  short  of  breath,  especially  on  going  upstairs. 

Appetite  very  much  increased,  especially  for  meat,  and 
the  more  so  the  more  pronounced  the  symptoms  were.  The 
mental  symptoms  are  striking ;  she  is  averse  to  being  alone, 
which  formerly  she  liked  (but  does  not  dread  it).  Her 
sexual  instincts,  formerly  dormant,  are  now  quite  strong ; 
wits  and  intuitions  dull  and  languid. 

Nov.  10.  The  prover  reports  :  She  had  been  quite  well 
since  the  4th,  and  supposed  the  action  of  the  drug  exhausted, 
but  on  the  7th  the  bearing  down  sensation  in  the  pelvis 
returned ;  everything  seemed  to  be  pressing  out  of  the 
vagina.  This  continued  on  the  8th  like  light  labor  pains. 
Leucorrhcea  also  occurred  (a  thin  acrid  discharge,  leaving 
a  brown  stain).  She  had  never  before  had  it.  All  these 
symptoms  worse  afternoon  and  evening  till  midnight.  On 
the  Qth  leucorrhcea  had  ceased,  but  in  the  afternoon  it 
returned  worse  than  ever,  and  she  could  not  sleep  for  the 
pelvic  distress. 


LILIUM   TIGRINUM.  359 

Nov.  ii.  She  feels  depression;  has  pressure  on  bladder 
and  rectum ;  is  inert,  yet  restless  and  peevish ;  leucorrhoea 
continues.  With  these  symptoms  comes  the  desire  again 
for  meat.  Burning  pain  across  the  hypogastrium  from  groin 
to  groin.  In  short,  the  symptoms  first  experienced  repeat 
themselves.  She  had  not  taken  any  more  of  the  Lilium 
tigrinum.  In  addition  she  notices  a  peculiar  mental  con- 
dition ;  a  desire  for  fine  things  of  every  kind.  She  is  dis- 
satisfied with  what  she  has,  and  envious  of  others. 

Nov.  12.  While  attending  a  lecture,  much  irritation  in 
the  womb  and  a  singular  state  of  mind — desire  to  strike  the 
lecturer,  and  in  the  evening  a  disposition  to  swear  at  every- 
body and  everything,  and  to  think  and  speak  of  obscene 
things ;  as  these  feelings  came,  the  uterine  pains  passed  away. 
To-day  the  leucorrhoea  ceased. 

Nov.  13.  She  has  been  languid,  dull,  and  forgetful  since 
the  last  report.  Menses  recurred  (i4th)  after  an  interval  of 
only  two  weeks ;  a  slight,  dark,  thick,  and  offensive  dis- 
charge. 

Dec.  i.  It  is  eight  weeks  since  she  took  Lilium  tigrinum. 
Yesterday,  great  hunger,  and  she  ate  largely,  yet  felt  as  if 
she  should  starve.  Felt  the  old  hurry  and  incapacity ;  the 
old  pains  in  head  and  teeth  relieved  by  motion  and  occupa- 
tion, followed  by  the  diarrhoea  and  the  pressure  on  the 
bladder. 

Dec.  4.  She  is  now  passing  this,  the  third  series  of 
symptoms  produced  by  the  Lilium  tigrinum ;  the  passionate 
excitement,  the  aching  and  burning  pain  in  the  ovaries  (in 
the  right),  which  organs  are  distinctly  defined  to  her  sensa- 
tion ;  then  despondency  with  aggravation  at  night  and 
diarrhcea  in  the  morning;  then  pressing  down  in  the  pelvis 
and  burning  all  around  the  pubes  and  genitals,  worse  from  3 
to  5  P.  M.,  and  passing  away  from  8  P.  M.,  accompanied  by 
pressure  on  the  bladder. 

The  symptoms  on  this  occasion  were  so  severe  and  dis- 
tressing— physical  no  less  than  mental — that  I  could  not 


360  LILIUM    TIGRINUM. 

allow  the  prover  to  continue  to  endure  them,  and  gave 
Platina200  repeatedly,  under  which  she  gained  speedy  relief. 

No.  2.  To  compare  with  the  above,  I  will  give  an  abstract 
of  a  proving  made  under  the  supervision  of  Dr.  W.  E. 
Payne,  at  about  the  same  time,  the  provers  having  no  com- 
munication : 

Mrs.  P.,  aged  55,  has  ceased  to  menstruate. 

Jan.  26,  1870,  took  a  drop  of  the  w  centesimal.  In  the 
evening,  after  griping  pain,  had  free,  faecal  stool,  followed  by 
acrid  feeling  in  anus  and  rectum,  a  very  rare  thing  for  this 
prover.  During  the  night,  a  feeling  in  all  the  extremities  as 
if  the  blood  were  pushed  outward  ;  restlessness ;  heat  and 
pain  in  forehead  and  brow. 

Next  day  a  free  stool,  followed  by  acrid  sensation  at  the 
anus.  Frequent  desire  to  urinate  during  the  day,  with 
scanty  discharge  and  followed  by  an  acrid  sensation  in  the 
urethra.  These  symptoms  recurred  daily  with  marked 
aggravation  about  5  P.  M.  till  February  2.  Diarrhceic  stool 
every  morning,  followed  by  acrid  irritation  at  anus,  con- 
tinuing about  an  hour.  Same  symptoms  with  urine. 

Feb.  2.  Repeated  medicine.  Increase  of  the  above 
symptoms ;  burning  in  palms  and  soles  all  night,  with  con- 
stant desire  to  find  a  cool  place  for  them ;  some  cutting  pain 
in  the  left  mammary  gland,  with  aching,  beginning  below 
the  nipple,  deep  in  the  breast,  as  though  between  the  gland 
and  the  ribs  and  extending  around  that  side  to  the  spine, 
seeming  to  pass  under  the  lower  end  of  scapula,  coming 
on  after  retiring  and  worse  when  lying  on  the  affected 
side. 

These  symptoms  continued  and  recurred  daily;  she 
repeated  the  medicine,  which  was  followed  by  a  severe  blind- 
ing headache  in  the  anterior  part  of  the  head,  the  peculiarity 
of  which  was  a  sensation  as  if  all  the  blood  were  pressing 
outward  through  every  aperture.  The  medicine  was  repeated 
every  third  or  fourth  day.  About  the  pth  and  loth,  in  the 
left  side  of  the  abdomen  (ovarian  region)  soreness  to  press- 


LILIUM   TIGRINUM.  361 

ure ;  darting  pains  at  times  in  this  region,  extending  to  the 
groin  and  pubes  in  front ;  frequent  desire  to  urinate. 

On  the  1 2th,  the  head  being  clearer  and  better,  great 
heaviness  and  pressure  in  the  region  of  the  womb,  with 
stinging  and  darting  pain  in  the  ovarian  region. 

I4th.  The  ovarian  pains  become  more  decided  and  ex- 
tend down  the  left  thigh. 

This  series  of  symptoms  continued  until  the  2 1st,  when 
the  ovarian  pain  continuing,  there  was  also  a  bearing  down 
in  the  uterine  region,  with  a  desire  to  sustain  the  parts  by 
pressing  upward  with  the  hand  against  the  vulva ;  symp- 
toms which  continued  and  are  described  on  the  25th  as  a 
"  pressing  and  bearing  down  sensation  "  in  the  whole  of  the 
sexual  organs,  with  a  feeling  as  if  the  internal  parts  were 
being  pulled  outward  and  downward  from  the  mammary 
and  umbilical  region  through  the  vagina;  irresistible  desire 
to  press  the  hands  against  the  vulva  to  prevent  the  internal 
organs  from  escaping. 

These  symptoms  continued  to  recur  for  a  full  month  after 
the  last  dose  of  Lilium,  and  the  morning  diarrhoea  for  more 
than  six  weeks. 

No.  3.  This  prover  took  Lilium3  in  one  dose  a  quarter 
ounce.  No  symptoms  were  observed  for  two  weeks.  Then, 
of  which  the  most  striking  were  those  last  in  order,  pain  in 
the  lumbar  region  as  though  the  back  would  break ;  bearing 
down  pain  in  the  pelvis,  especially  when  walking ;  pressure 
and  weight  low  down  in  the  vagina. 

She  reports,  also,  a  headache,  as  if  the  head  were  too  full 
of  blood — as  if  the  blood  would  issue  from  nose  and  ears. 

No.  4.  This  prover,  who  had  suffered  from  astigmatism, 
and  was  hypermetropic,  experienced  from  Lilium3,  heart 
symptoms,  pain  through  the  heart  to  the  back,  and  a  feeling 
as  if  the  heart  were  squeezed  in  a  vice.  She  cannot  walk 
straight  by  going  into  a  warm  room,  the  symptoms  having 
occurred  while  walking  in  cold  air. 

Also,  her  eyesight  became  very  dim.     She  took  no  more 


362  LILIUM   TIGRINUM. 

medicine,  and  in  about  a  month  her  eyesight  was  restored. 
She  then  found  that  the  astigmatism  no  longer  existed. 

No.  5.  This  prover  describes  the  same  headache  as  the 
previous  prover — pressure  from  within  outward ;  the  same 
nervous  prostration,  and  a  morning  diarrhoea  with  much 
tenesmus.  She  states  the  symptoms  persisted  for  a  month 
after  the  last  dose. 

No.  6.  This  prover  reports  nervous  tremulousness  and 
inability  to  apply  the  mind ;  aggravation  in  the  afternoon, 
and  a  headache  similar  to  the  preceding.  Also,  menses 
diminished  in  quantity,  but  occurring  too  soon.  Likewise, 
severe  pains  in  the  uterus;  could  not  bear  the  weight  of 
clothing  on  the  pelvis ;  profuse  acrid  leucorrhcea.  While 
the  pain  in  the  pelvis  was  so  severe,  a  vaginal  examination 
disclosed  the  fact  that  the  uterus  was  anteverted ;  a  state  of 
things  that  had  never  before  existed.  During  the  pains 
hysterical  paroxysms. 

Nos.  7.  and  8.     The  same  series  of  symptoms  as  above. 

From  this  resume  we  may  gather  some  of  the  chief  charac- 
teristics of  Lilium.  When  taken  in  moderate  doses  the 
effects  are  not  immediate.  Days  elapse  before  unmistak- 
able symptoms  of  the  drug-action  appear.  But  the  effects 
are  very  persistent,  as  the  record  of  every  prover  shows. 
They  tend,  moreover,  to  recur  at  longer  or  shorter  intervals, 
and  in  groups  which  preserve  a  definite  order.  Thus,  prover 
No.  i,  whose  record  I  have  given  at  greater  length,  reports 
a  third  recurrence  of  a  group  of  symptoms  nearly  two  months 
after  the  dose  of  Lilium.  In  male  provers  the  same  recur- 
rence of  symptoms  in  definite  groups  has  been  observed,  with 
an  interval  of  comparative  freedom  from  symptoms.  The 
simultaneous  observation  of  these  peculiarities  in  provers 
residing  far  from  each  other,  and  not  known  to  each  other, 
precludes  any  doubt  of  its  genuineness. 

Of  the  symptoms  observed  by  women,  as  well  as  men,  the 
effects  on  the  mind  are  noteworthy,  and  are  of  two  varieties. 
First,  as  noticed  by  Dr.  Payne,  anxiety  and  apprehension 


LILIUM   TIGRINUM.  363 

that  an  incurable  disease  exists  or  is  impending,  and  this 
produces  despondency.  Second,  as  exhibited  most  decidedly 
in  prover  No.  I,  and  clearly,  though  less  pronounced,  in 
several  others,  a  consciousness  of  an  unnatural  state  of  mind 
and  feeling,  which  at  last  develops  into  an  exalted  condition 
in  which  the  prover  is  disposed  to  find  fault  with  persons 
and  things,  to  exaggerate  her  own  importance  and  excellence, 
and  look  down  upon  others;  conjoined  with  this  is  an  exal- 
tation of  the  sexual  instinct.  In  several  provers  this  state  of 
things  has  resulted  in  hysterical  paroxysms.  In  prover  No. 
I  it  assumed  such  marked  proportions  that  I  was  constrained 
to  put  an  end  to  it  by  administering  Platina,  the  indications 
for  which  are  evident  from  the  mental  symptoms.  Intel- 
lectual activity  is  impaired  in  both  men  and  women.  Both 
have  complained  of  the  feeling  of  hurry  and  restlessness, 
which  is  so  well  described  by  prover  No.  I. 

Menstruation  is  accelerated,  in  some  cases  recurring  in 
two  weeks.  The  flow  is  very  scanty. 

An  acrid,  thin,  brownish  leucorrhoea  was,  to  several  prov- 
ers, a  troublesome  symptom. 

But  the  most  striking  symptoms,  and  those  most  widely 
observed,  relate  to  the  pelvic  organs.  They  did  not  gener- 
ally present  themselves  until  a  number  of  days  after  the 
proving  was  begun.  They  consist  of  a  dragging  or  pulling  or 
forcing  down  sensation  in  the  pelvis,  as  though  the  entire 
contents  of  the  pelvis  were  pulled  down  through  the  vagina, 
or  would  issue  from  the  vulva.  This  sensation  is  not  con- 
fined to  the  back  or  hips, — nor  again  to  the  hypogastric 
region, —  but  is  described  as  pervading  the  entire  pelvis. 
And  the  two  provers  in  whom  this  symptom  was  most 
marked  describe  the  dragging  as  coming  even  from  the 
thorax,  the  mammary  region,  and  the  shoulders.  So 
marked  is  the  sensation  of  downward  and  outward  pressure 
that  the  provers  place  the  hand  on  the  hypogastrium  or  the 
vulva  as  though  to  prevent  protrusion.  In  three  provers, 
physical  inspection  revealed  the  existence  of  anteversio 


364  LILIUM  TIGRINUM. 

uteri,    a   trouble   which    none    of    them    had    ever   before 
experienced. 

In  this  train  of  symptoms  belong  also  the  tenesmus  of 
bladder  and  rectum,  and  the  diarrhoea  and  frequent  micturi- 
tion. 

There  is  agreement  of  the  provers  respecting  pains,  burn- 
ing or  cutting,  and  tenderness  in  the  region  of  the  ovaries, 
especially  of  the  right  ovary. 

The  symptoms  generally  are  worse  in  the  afternoon  and 
before  midnight,  except  the  diarrhoea,  which  seems  to  be  a 
morning  diarrhoea. 

If  now,  with  the  light  which  these  provings  afford  us,  we 
seek  to  place  Lilium  tigrinum  in  its  appropriate  niche  in 
our  Materia  Medica,  and  to  estimate  its  value  by  comparison 
with  other  drugs,  we  observe,  first :  The  uniform  occurrence, 
in  so  many  provers,  of  pelvic  symptoms,  as  well  as  the 
demonstration,  by  physical  examination,  of  the  uterine  dis- 
placement, establish  its  a  priori  claim  to  rank  among  the 
remedies  for  prolapsus  and  displacement  of  the  uterus,  for 
catarrh  of  vagina  and  uterus,  and  for  inflammation  of  the 
ovary.  And  if  we  run  a  parallel  with  the  symptoms  of  other 
remedies,  we  find  marked  peculiarities  which  characterize 
Lilium.  In  the  morning  diarrhoea,  coming  suddenly  and 
with  tenesmus,  it  resembles  Podophyllum,  and  Podophyllum 
has,  likewise,  a  general  bearing  down  in  the  pelvis — con- 
fined, however,  to  the  lumbo-sacral  region,  while  the  mental 
and  moral  symptoms  produced  by  Podophyllum  bear  no 
resemblance  to  those  of  Lilium.  Moreover,  in  so  far  as  my 
own  observation  goes,  Podophyllum  both  produces  and 
removes  these  pelvic  symptoms  only  when  they  occur  in 
connection  with  certain  symptoms  of  the  digestive  tract, 
such  as  Lilium  has  no  relation  with. 

Sepia  produces,  certainly,  a  bearing  down  sensation  upon 
the  lumbar  region,  together  with  dragging  and  even  sharp 
pains  from  the  region  of  the  ovaries  extending  downward  to 
the  pudenda,  but  besides  that,  Sepia  presents  us  no  symp- 


LILIUM  TIGRINUM.  365 

toms  of  diarrhoea  and  irritation  of  rectum  and  anus,  and  no 
such  leucorrhcea  as  Lilium ;  the  conditions  are  very  different. 
The  Lilium  pains  are  aggravated  in  the  afternoon,  and 
before  midnight.  They  grow  worse  during  repose  and 
when  one's  mind  is  passive ;  worse,  therefore,  on  lying  down 
and  trying  to  compose  one's  self  to  sleep.  Whereas,  on  the 
other  hand,  the  Sepia  pains  are  worse  from  9  A.M.  to  noon, 
and  are  relieved  by  repose ;  being  aggravated  by  motion 
and  occupation.  The  state  of  mind  produced  by  the  two 
drugs  is  very  different.  Almost  the  same  differences  exist 
between  Lilium  and  Pulsatilla. 

Belladonna  resembles  Lilium  in  the  bearing  down  sensa- 
tion, both  in  the  back  and  in  the  pubic  region,  and  in  the 
fact  that  there  is  not  immediate  relief  from  repose.  But, 
on  the  other  hand,  Lilium  gives  no  evidence  of  that  general 
affection  of  the  organism,  especially  of  the  circulation, 
which  accompanies  every  well  pronounced  group  of  Bella- 
donna symptoms.  On  the  contrary,  under  Lilium,  when 
the  patient  suffered  most,  nutrition  and  appetite  were  not 
impaired.  They  were  even  improved. 

It  is  probable  that  further  provings  of  Helonias  dioica 
will  show  a  strong  analogy  between  it  and  Lilium  as  regards 
their  action  on  the  female  organism.  We  know  enough 
already  to  recognize  a  difference  in  the  mental  symptoms. 
Lilium  dulls  the  intellect,  produces  a  sensation  of  hurry 
with  inability,  and  a  distress  based  on  a  clearly  defined 
apprehension  of  having  some  fatal  or  serious  malady. 
Helonias  produces  profound  melancholy,  deep,  undefined 
depression,  with  sensation  of  soreness  and  weight  in  the 
womb,  a  "  consciousness  of  a  womb." 

Platina  seems  to  me  to  present  the  strongest  features  of 
resemblance  to  Lilium,  both  in  the  pelvic  symptoms  and  in 
at  least  one  phase  of  mental  symptoms,  and  the  result  of 
my  trials  with  prover  No.  I  shows  its  power  to  antidote 
Lilium.  But  Platina  does  not  present  any  of  the  symp- 
toms of  the  intestinal  tract  which  are  so  prominent  under 


366  LILIUM   TIGRINUM. 

Lilium  nor  are  its  effects  on  the  function  of  menstruation 
similar. 

It  will  be  observed  that  I  have  said  nothing  of  the  action 
of  Lilium  upon  the  heart.  This  is  because  my  provers  were 
not  very  markedly  affected  in  that  way  (except  one  of 
them),  but  chiefly  because  my  purpose  was  to  show  the 
action  of  the  drug  on  the  organs  and  functions  peculiar  to 
women,  and  to  demonstrate  how  valuable  additions  may  in 
a  short  time  be  made  to  Materia  Medica  in  its  weakest  part 
by  the  labors  of  professionally  educated  women  heartily 
engaged  in  this  work,  which  none  but  such  as  they  can 
perform. 


MUREX  PURPUREA. 


This  substance  was  first  introduced  into  the  Materia 
Medica  by  Dr.  Petroz,  of  Paris,  in  some  observations 
published  in  the  Revue  Critique  et  Retrospective  de  la  Matiere 
Medicate,  vol.  iii.,  1841. 

Dr.  Petroz  does  not  state  from  what  variety  of  the  mollusk 
which  furnishes  the  purple  coloring  matter  the  specimen 
employed  by  him  in  the  proving  was  obtained.  A  coloring 
substance,  to  all  appearance  identical,  is  found  in  various 
genera  of  the  family  Muricidae  as  well  as  in  the  genus 
purpura  of  the  family  Buccinidae. 

Weber,  of  Paris,  in  his  Codex  des  Medicaments  Homceo- 
pathiques  on  pharmacopee  pratique  et  raisone'e,  has  the 
following  remarks : 

"  MUREX  PURPUREA.  Coquille  a  pourpre.  It  belongs 
to  the  class  of  mollusks  and  to  the  family  of  Purpurifera. 
There  are  several  varieties  which  may  have  the  same  value 
in  Homreopathy,  inasmuch  as  up  to  the  present  day  the 
only  part  used  for  experimentation  has  been  the  coloring 
matter  which  furnishes  the  purple,  and  even  this  experimen- 
tation has  been  made  not  upon  the  healthy  subject,  but 
upon  the  sick. 

"The  ancients  derived  their  purple  dye  from  several 
different  mollusks,  from  the  Biccinum,  a  variety  found  upon 
the  rocks,  as  well  as  from  the  Purpurea,  which  is  the 
"  Coquille  a  pourpre,"  properly  so-called,  and  which  is 
found  not  only  upon  the  Phoenician  coast,  but  also  through- 
out the  Mediterranean.  Recently  a  juice,  analogous  to  the 
purple  dye,  has  been  found  in  several  conchiferae  belonging 
to  the  family  of  the  Limacidae.  This  juice,  which  is  viscous, 


368  MUREX   PURPUREA. 

and,  when  first  obtained,  colorless,  is  found  in  a  distinct 
little  sac  which  in  the  majority  of  these  mollusks  is  situated 
between  the  heart  and  the  liver.  When  brought  into 
contact  with  the  atmosphere  this  juice  becomes  successively 
yellow,  green,  blue  and  finally  a  reddish  purple. 

"  It  is  insoluble  in  water,  alcohol  or  ether  ;  consequently, 
for  homoeopathic  use,  the  first  three  attenuations  should  be 
prepared  by  trituration." 

Jahr  and  Catellan,  in  their  Pharmacopeia,  Paris,  1853,  say : 

"  MUREX  PURPUREA,  purpura  patula,  cochlea  veram  pur- 
puram  fundens ;  pourpre  antique ;  Purpurschnecke.  An 
oval  shell  furrowed  transversely,  studded  with  tubercles, 
especially  when  young ;  with  a  somewhat  short  helix,  the 
aperture  bell-mouthed.  Color,  a  blackish  russet  externally. 
The  columella  of  a  russet  yellow.  The  straight  margin 
white.  This  variety  of  shell  inhabits  the  Mediterranean, 
where  it  is  pretty  common.  Its  juice,  which  is  the  true 
purple  dye,  is  contained  in  a  large  fold  in  the  form  of  a 
pocket  upon  the  back  near  the  neck.  It  requires  a  good 
deal  of  adroitness  to  collect  this  juice,  for  it  is  quickly  thrown 
out  by  the  animal.  The  juice,  after  being  taken  from  the 
animal,  is  at  first  blue,  and  then  of  a  beautiful  green,  finally 
of  a  magnificent  purplish  red.  Cloth  dyed  with  it  always 
preserves  its  color." 

The  provings  recorded  by  Dr.  Petroz,  and  which  are  the 
only  ones  that  we  possess,  are,  it  must  be  confessed,  frag- 
mentary. So  are  the  contributions  of  every  individual 
prover  of  every  drug.  So  are  the  single  stones,  of  which 
when  they  are  duly  placed  together,  a  stately  mansion  is 
constructed.  If  the  stones  were  neglected,  because,  when 
regarded  separately,  they  are  nothing  like  a  house,  how  could 
they  ever  be  brought  together  and  built  up,  forming  the 
house  ?  If  the  results  of  each  individual  prover's  or  experi- 
menter's labors  are  to  be  withheld  on  the  ground  that  they 
are  fragmentary,  how  shall  matter  be  accumulated  for  a 
complete  and  exhaustive  proving  ? 


MUREX 


PURPUREA.  369 


It  has  been  further  objected  that  Dr.  Petroz's  proving  is 
not  a  pure  one,  because  his  subjects  had,  two  of  them  a 
slight  leucorrhcea,  and  the  third  a  cutting  uterine  pain  at 
the  time  of  the  menstrual  flow.  Some,  chief  among  them 
Dr.  Roth,  of  Paris,  would  rigorously  exclude  from  the 
Materia  Medica  Pura  everything  which  does  not  rest  upon 
exact  observation  of  the  effect  of  drugs  upon  exclusively 
and  strictly  healthy  persons. 

Etymologically,  he  is  quite  correct.  A  pure  Materia 
Medica  has  no  business  with  a  single  symptom  obtained 
from  observation  on  the  sick,  however  slightly  sick,  or  sick 
in  a  way  however  foreign  to  the  nature  of  the  symptom  in 
question. 

But  in  good  part,  the  criticism  of  Dr.  Roth  is  sheer 
pedantry,  not  practical  sagacity. 

An  ideal  Materia  Medica  Pura  should  contain  only  symp- 
toms obtained  upon  the  absolutely  healthy.  Ages  will 
elapse  before  we  can  have  a  complete  Materia  Medica  of  this 
kind.  It  is  certainly  an  object  worthy  of  unceasing  labor. 

The  Materia  Medica  which  we  possess  while  made  up  in 
good  part  of  pure  symptoms  (symptoms  observed  upon  the 
absolutely  healthy),  contains  also  symptoms  observed  upon 
those  who  are  not  absolutely  healthy.  The  symptoms  we 
possess  of  certain  medicines  are  wholly  of  the  latter  char- 
acter. Cases  occur  in  practice  to  which  no  remedy  of  which 
we  have  pure  symptoms  corresponds,  but  which  nevertheless 
finds  its  simile  and  its  individual  specific  in  one  of  these 
drugs  of  which  we  have  no  knowledge  except  the  symptoms 
it  has  produced  upon  the  sick. 

Now,  the  pedantry  of  the  critic  in  his  closet  may  exclude 
from  a  pure  Materia  Medica  every  proving  that  is,  so  to 
speak,  impure,  but  the  question  for  the  practical  man  is  this: 
Shall  any  proving,  however  fragmentary,  however  impure, 
which  yet  puts  it  in  the  power  of  the  physician  to  cure  even 
a  single  case  of  disease,  be  cast  out  from  the  Materia 
Medica  ?  The  answer  must  be,  let  it  remain  for  the  sake  of 
25 


370  MUREX   PURPUREA. 

these  rare  cases  as  a  stimulus  to  pure  and  complete  provings, 
as  a  contribution  to  the  clinical,  if  not,  in  pedantic  literal- 
ness,  to  the  pathogenetic  history  of  the  drug ! 

The  point  of  greatest  importance  in  relation  to  the  frag- 
mentary provings,  which  are  published  from  time  to  time, 
and  from  a  collection  of  which  an  exhaustive  knowledge  of 
the  drug  is  ultimately  to  be  obtained,  seems  to  us  to  be  this, 
that  the  name  and  condition  of  the  prover  should  be  attached 
to  each  symptom,  and  that  thus  the  student  may  be  enabled 
to  judge  for  himself  of  the  pureness  and  authenticity  of  the 
symptoms. 

The  observations  of  Dr.  Petroz  are  given  in  the  following 
with  but  little  abbreviation.  They  are  followed  by  some 
clinical  observations  by  Dr.  Constantine  Hering  and  other 
practitioners.  All  together,  these  remarks  should  serve  to 
draw  attention  to  Murex  purpurea  as  a  substance  promising 
rich  returns  to  the  careful  prover. 

MUREX  PURPUREA,  by  Dr.  Petroz,  of  Paris,  from  La 
Revue  Critique  et  Retrospective  de  la  Matter e  Medicale  : 

The  entire  scope  of  the  action  of  therapeutic  agents  is 
not  easily  recognized,  even  by  those  who  have  a  profound 
understanding  of  the  Materia  Medica  based  on  experimenta- 
tion on  the  healthy  subject. 

This  difficulty  explains  the  astonishment  of  practitioners 
when  they  meet  with  unexpected  results,  the  products  of 
some  particular  condition  different  from  that  which  consti- 
tutes the  physiological  state.  The  observations  of  these 
effects  in  conditions  very  similar  to  each  other,  if  collected 
with  care,  should,  after  a  time,  constitute  the  second  part  of 
the  Materia  Medica,  which  we  might  call  the  clinical,  in 
.contradistinction  to  the  pure  or  experimental  part. 

The  latter,  however,  the  fundamental  basis  of  the  art  of 
curing,  should  be  regarded  as  an  inviolable  law,  the  point  of 
departure  of  every  positive  notion,  the  sacred  volume  to 
which  we  faithfully  recur  on  every  occasion  on  which  we 
may  have  been  led  away,  by  a  sort  of  involuntary  impulse  as 


MUREX   PURPUREA.  3/1 

it  were,  to  that  empiric  method  which  has,  up  to  the  present 
time,  characterized  the  successively  prevailing  doctrines. 

Experimentation  on  the  healthy  subject,  while  it  produces 
symptoms  analogous  to  the  majority  of  those  observed  in 
the  sick,  has  not  been  able  to  go  so  far  as  to  produce  those 
disorders,  whether  functional  or  material,  so  serious,  and  yet 
so  common,  which  appall  the  most  practiced  and  hardened 
observer. 

That  the  proving  of  a  medicinal  substance  upon  the 
healthy  subject  should  make  known  all  the  effects  which  it 
is  capable  of  developing,  it  must  be  repeated  not  only  under 
different  conditions  of  age,  sex,  etc.,  but  also  under  variable 
conditions  of  susceptibility.  But  even  if  one  succeed  in 
finding  healthy  individuals  of  very  unusual  susceptibility, 
this  is  but  trifling,  compared  with  the  susceptibility  which 
characterizes  certain  pathological  conditions. 

Furthermore,  where  is  the  physician,  who,  whatever  his 
devotion  to  science,  would  assume  the  right  of  pushing  his 
proving  to  the  extent  of  endangering  the  life  of  the  prover. 

This  difficulty  of  pushing  experimentation  far  enough  to 
discover  every  medicinal  property  which  a  substance  may 
possess  is  relative,  as  I  have  said  above,  to  the  susceptibility 
of  the  prover.  Thus  a  young  woman,  very  impressible  and 
courageous,  presented  to  me,  when  under  the  influence  of 
Lycoperdon  Bovista,  symptoms  which  were  the  very  image 
of  asphyxia  from  the  fumes  of  charcoal.  *  *  * 

In  proving  a  mimosa  asperata  she  experienced  several  epilep- 
tiform  nervous  symptoms. 

But  it  is  a  rare  thing  to  find  individuals  so  well  adapted  to 
this  work.  In  default  of  them  we  must  interrogate  the  path- 
ological susceptibility,  which,  in  its  turn,  may  prove  a  fruitful 
source  of  positive  knowledge. 

PATHOGENESY. 

No.  I.  A  woman,  46  years  old,  of  nervous  tempera- 
ment, very  impressible,  but  in  good  health. 


372  MUREX   PURPUREA. 

One  dose  of  Murex,  fourth,  was  taken  in  six  spoonfuls  of 
water.  The  first  spoonful  was  taken  January  5th,  in  the 
evening. 

Twelve  hours  after  taking -the  medicine,  acute  pain  in  the 
right  side  of  the  uterus,  which  crossed  the  entire  body  and 
extended  upward  to  the  left  breast ;  extreme  feebleness  of  all 
voluntary  motions,  the  legs  bend  under  her;  irresistible 
necessity  of  remaining  seated ;  confusion  of  ideas,  repug- 
nance to  conversation,  deep  sadness. 

At  six  P.  M.,  palpitations  of  the  heart,  and  throbbings  of 
the  arteries  in  the  neck. 

In  the  evening,  excessive  fatigue,  somnolence,  heat  of  the 
hands ;  pulse  80.  Pains  in  the  knees ;  pains  in  the  loins, 
sensation  of  excoriation  and  of  burning  pain,  as  if  broken, 
in  the  chest.  The  night  was  good. 

January  /th.  The  second  spoonful,  in  the  evening.  Sharp 
burning  pain  under  the  false  ribs  of  the  left  flank,  toward 
the  vertebral  column,  in  paroxysms ;  somnolence  and  sad- 
ness ;  difficult  evacuation  of  faeces,  stool  requiring  an  enema 
of  tepid  water.  The  stitch  in  the  side  has  lasted  the 
whole  day.  In  the  evening,  painful  tension  in  the  right 
hypochondrium.  Dry,  infrequent  cough.  Dyspnoea.  Voice 
is  changed  and  hoarse.  The  heaviness  is  much  diminished. 
No  leucorrhoea  since  the  first  spoonful. 

The  third  spoonful  on  the  evening  of  the  seventh. 

8th.  The  night  good.  On  awaking,  feels  well.  The  stitch 
in  the  side  has  disappeared.  Sensation  of  dryness  and  of  con- 
striction in  the  uterus.  The  heaviness  has  disappeared.  No 
leucorrhcea. 

The  fourth  spoonful  was  taken  on  the  evening  of  the 
eighth. 

9th.  A  good  day.  Natural  stool.  Fifth  spoonful,  eve- 
ning. 

loth.  Very  good  day.     Sixth  spoonful. 

nth.  In  the  morning,  a  sensation  of  heaviness  and  of 
dilation  in  the  labia  majora.  The  urine  has  a  white  deposit. 


MUREX   PURPUREA.  373 

Expulsion  of  a  small  quantity  of  bloody  mucus,  after  passing 
water. 

1 2th.  A  good  day.  In  the  evening  the  menses  appeared 
abundantly.  Stool  natural. 

1 3th.  Pain  in  the  uterus,  as  if  wounded  by  a  cutting 
instrument  This  sensation  has  been  habitual  during  the 
menstrual  flow  for  many  years. 

No.  2.  A  woman,  aged  38  years,  of  a  sanguine  tempera- 
ment, sound  mind,  judicious  powers  of  observation,  good 
health. 

First  day.  The  leucorrhoea  having  disappeared  entirely, 
pain  in  the  occiput  toward  midday,  pain  in  the  arms  below 
the  elbow. 

Second  day.  On  awaking,  headache,  which  disappears  on 
getting  up.  During  the  day  pains  in  the  left  temple,  com- 
ing and  going.  *  *  Toward  the  close  of  the  day, 
tightness  in  the  occiput ;  I  involuntarily  raise  my  hand  to  the 
part  affected,  when  the  tightness  passes  from  left  to  right;  I 
raise  to  the  head  the  hand  of  the  opposite  side  to  that  which 
is  the  seat  of  the  pain ;  I  bend  my  head  backward  because 
it  seems  to  me  that  this  motion  relaxes  the  nerves  of  the 
occiput  and  of  the  neck ;  constant  desire  to  urinate  during 
the  day ;  at  three  o'clock  in  the  afternoon,  great  desire  to 
sleep. 

Third  day.  Headache  as  the  evening  before,  and  relieved 
in  the  same  way;  sleep  with  troublesome  dreams;  I  fled 
from  a  troubled  sea  and  found  myself  again  in  a  meadow 
with  water ;  during  the  day  momentary  heaviness  of  the 
head ;  at  five  o'clock  my  right  cheek  was  burning ;  in  the 
evening,  twice,  I  had  a  very  violent  stitch  on  the  left  side  of 
the  abdomen,  downward ;  it  ascended  perpendicularly  and 
lasted  one  minute;  at  nine  o'clock,  violent  sleepiness. 
During  the  day,  pains  in  the  legs  from  time  to  time,  tight- 
ness in  the  head  on  each  side  above  the  ears ;  pains  in  the 
breasts. 

Fourth  day.     Painful  dreams,  headache  on  waking     *     * 


374  MUREX   PURPUREA. 

pretty  severe  colic ;  hunger  during  the  day ;  appetite  pretty 
good  in  the  morning,  but  not  at  dinner ;  pains  in  the  breasts. 

Fifth  day.  I  will  explain  to  you.  The  prover  has  not 
dared  write  all  that  she  has  felt  in  the  region  of  the  genital 
organs;  excessive  sexual  desire,  an  excitement  which  will 
and  reason  could  hardly  control. 

Sixth  day.  The  left  cheek  burning.  Hunger  during  the 
day ;  in  the  evening,  headache  with  pain,  lasting  about  an 
hour. 

Seventh  day.  Troublesome  dreams ;  waked  with  a  start, 
in  fear ;  in  the  morning,  leucorrhoea,  very  scanty,  but  green- 
ish ;  in  the  evening,  flatulent  colic.  This  is  the  seventh  day 
of  medication,  and  since  the  second  day  I  have  been  very 
much  constipated ;  to-day  I  could  not  go  to  stool ;  in  the 
evening  I  had  headache  in  front  of  the  forehead.  I  have 
forgotten  to  say  that,  during  the  first  days,  in  the  morning 
before  breakfast,  I  coughed  several  times.  In  the  evening, 
when  breathing,  I  had  wheezing  in  the  chest;  for  several 
days,  I  experience,  during  the  day,  paroxysms  of  anguish, 
of  fear  and  dread. 

No.  3.  A  woman,  aged  39  years,  of  sanguine-lymphatic 
temperament. 

First  day.  At  two  o'clock  and  at  four,  I  have  had  sharp 
but  transient  pains  above  the  cerebellum.  Less  of  leucor- 
rhoea, but  always  mixed  with  blood. 

Second  day,  Friday.  Since  noon,  the  head  embarrassed 
and  a  little  heavy;  little  disposition  to  work;  at  half-past 
two  o'clock,  buzzing  in  the  ears,  and  increased  heaviness  in 
the  head,  relieved  about  four  o'clock ;  about  half- past  six,  I 
was  taken  with  a  sharp  pain  in  the  abdomen  on  the  left  side. 
It  was  acute  and  extended  over  the  whole  abdomen ;  not 
equally  intense,  but  felt  in  different  spots,  like  a  sharp  point ; 
the  left  side  of  the  abdomen  remained  sore  the  whole  even- 
ing. The  leucorrhcea  scanty  and  not  mixed  with  blood.  In 
bed,  pains  in  the  renal  and  lumbar  regions,  and  a  decided 
heat  above  the  thighs  persistent. 


MUREX   PURPUREA.  375 

Third  day,  Saturday.  Less  heaviness  of  the  head  ;  but 
little  leucorrhcea,  but  it  is  thicker ;  not  mixed  with  blood ; 
the  sore  spots  of  the  left  side  of  the  abdomen  are  less  sensi- 
tive, but  are  still  occasionally  felt ;  some  lancinating  pains ; 
the  heat  of  the  thighs  has  disappeared,  but  that  of  the  hip 
region  continues  even  when  not  recumbent. 

Fourth  day,  Sunday.  This  morning,  on  going  to  stool, 
the  blood  had  disappeared,  and  up  to  one  o'clock,  blood  was 
mingled  with  leucorrhcea ;  about  three  o'clock  I  experienced 
a  severe  pain  above  the  right  temple ;  a  little  pain  in  the 
thighs ;  I  have  remarked  that  since  taking  the  medicine  the 
pains  in  the  loins  and  hips  are  greater.  In  the  evening,  on 
going  to  stool,  the  blood  flowed  copiously;  this  day,  but 
little  'leucorrhoea.  For  two  days,  pains  in  the  breasts. 

Fifth  day,  Monday.  No  blood  to-day ;  but  little  leucor- 
rhcea ;  but,  on  rising,  pains  under  the  left  thigh,  very  sensi- 
ble on  touching  the  part.  This  continued  throughout  the 
day.  Some  lancinating  pains  in  the  womb ;  the  hips  are 
painful ;  no  heat  of  the  thighs,  either  in  bed  or  when  up. 

Sixth  day,  Tuesday.  No  blood;  but  little  leucorrhcea. 
The  pain  below  the  thigh  is  less  severe,  but  the  part  is 
always  sensitive  to  the  touch.  The  breasts  have  been  very 
painful,  and  in  bed  I  have  had  sharp  and  painful  lancinations 
in  them.  The  pains  of  the  thighs  and  of  the  loins  have 
almost  disappeared. 

Seventh  day,  Wednesday.  During  the  night  I  waked 
with  a  start,  and  a  violent  desire  to  urinate.  Urinated  very 
copiously.  No  blood  nor  leucorrhcea  during  the  night,  a 
good  deal  during  the  day.  Heaviness  of  the  head  and  even 
dizziness,  but  since  taking  the  medicine,  and  even  before,  I 
have  not  had  so  good  a  day.  I  have  observed  that  since 
taking  the  medicine  I  lose  my  memory,  and  even  find  my 
words  with  difficulty. 

.Eighth  day,  Thursday.  Ceased  to  take  the  medicine. 
The  day  has  been  a  very  bad  one.  Very  severe  pains  in 
the  breasts,  loins  and  thighs.  Distress  in  the  abdomen, 


376  MUREX   PURPUREA. 

resembling  that  which  I  feel  at  the  approach  of  the  menses ; 
and  we  are  now  at  the  2Oth  of  August, — they  should  not 
come  until  the  5th  of  September.  Desire  to  sleep,  dullness 
of  head ;  labor  is  irksome. 

This  evening,  no  more  pains  except  in  the  thighs,  always 
below  and  toward  the  middle.  When  urinating  during  the  day 
blood  appeared  slightly ;  scarcely  any  leucorrhcea,  but  very 
thick  and  yellow.  I  have  remarked  that  I  suffer  more  when 
sitting  than  when  walking,  and  the  pains,  which  I  cease 
to  feel  when  walking  to  and  fro,  return  almost  immediately 
when  I  resume  the  sitting  posture.  Good  sleep  and  appetite. 

Ninth  day,  Friday.  Good  night ;  yet  on  first  waking, 
and  also  several  times  during  the  night  on  waking,  I  had 
pretty  severe  pains,  such  as  attend  the  menses  ;  anguish. 

The  breasts,  to-day,  have  been  less  painful;  no  more 
blood  in  the  leucorrhoea,  and  at  stool  scarce  any  leucorrhcea  ; 
no  pain  in  loins  but  extreme  lassitude  and  pains  in  the  legs 
and  knees.  No  lancinations.  A  good  day. 

Headache,  however,  and  frequent  transient  sharp  pain  in 
the  right  temple.  My  headache,  which  continues  this 
evening  is  more  on  the  right  side  than  on  the  left. 

Clinical  Observations.  No.  i.  Madame  J.,  mother  of  several 
children  whom  she  nursed,  enjoyed  very  good  health  up  to 
her  forty-fifth  year.  At  this  period  she  began  to  have 
irregularity  of  the  menses  and  soon  to  complain  of  painful 
weariness  in  the  loins,  of  a  sensation  of  weight  in  the 
hypogastrium  and  more  particularly  in  the  rectum,  all  of  which 
gave  her  great  concern ;  deep  sadness  at  the  approach  of  the 
menses,  which  were  very  abundant  for  several  days,  and 
were  attended  with  great  pain  caused  by  the  expulsion  of 
large  coagula.  Subsequently,  the  flow,  which  lasted  ten  or 
twelve  days,  became  russet- colored  and  finally  serous.  The 
interval  from  one  period  to  the  next  was  only  about  ten 
days,  during  which  the  above  symptoms  diminished  without 
entirely  ceasing,  and  at  the  recurrence  of  the  menstrual  flow 
re-appeared  with  their  original  severity. 


MUREX   PURPUREA.  377 

Exploration,  by  means  of  the  speculum,  revealed  the  pres- 
ence of  a  soft,  violet-colored  enlargement  of  the  neck  of 
the  uterus ;  a  large  excoriation  on  its  anterior  aspect,  which 
was  caused  to  bleed  by  a  slight  touch,  induced  recourse  to 
cauterization,  after  which  the  patient  was  enjoined  to  observe 
absolute  repose  and  a  light  not  very  abundant  diet.  The 
menses  subsequent  to  the  operation  were  less  abundant, 
without  coagula  and  consequently  less  painful  and  of  shorter 
duration ;  the  secondary  symptoms  were  also  less  marked. 
This  improvement  did  not  last  longer  than  a  few  months, 
when  the  symptoms  returned  with  increased  violence. 
Walking,  or  standing  for  a  long  time  became  almost  impossi- 
ble ;  the  pain  at  the  appearance  of  the  menses  became  again 
violent,  for  the  expulsion  of  large  coagula;  during  the 
periods  of  suffering,  the  pulse  was  small  and  frequent; 
emission  of  urine  was  impossible ;  a  copious  sweat  covered 
the  patient's  body.  Sabina  33^,  in  120  grammes  of  water, 
given  in  spoonful  doses,  every  half  hour,  moderated  the 
severity  of  the  symptoms  without  much  abridging  their 
duration.  Eight  days  afterward  the  patient  took  Murex 
purpurea4,  five  centigrammes  in  180  grammes  of  water  (a 
spoonful  morning  and  evening). 

Under  the  influence  of  this  remedy,  the  painful  weariness 
of  the  loins,  of  the  thighs,  the  weight  upon  the  rectum,  the 
leucorrhcea,  the  itching  occasioned  by  it  and  the  pains  in  the 
hypogastrium  diminished  and  then  disappeared. 

The  menstrual  epoch,  which  was  retarded  several* days, 
occurred  as  before  the  sickness,  except  that  there  was  the 
weakness  resulting  from  the  antecedent  sufferings.  A  second 
dose,  like  the  first,  was  given,  immediately  after  the  cessation 
of  the  menses.  From  that  time  she  was  restored  to  perfect 
health.  Eighteen  months  have  elapsed,  during  which  she 
has  led  an  active  and  sometimes  a  fatiguing  life,  without  her 
health  being  at  all  impaired. 

No.  2.  Madame  F.,  30  years  of  age,  of  a  sanguine-lymphatic 
temperament,  mother  of  two  children,  was  subject,  in  infancy, 


378  MUREX    PURPUREA. 

to  violent  attacks  of  cough,  caused  by  congestion  of  the  lungs, 
the  results  of  a  psoric  taint  (retrocession  of  itch).  These 
attacks  ceased  to  appear  about  the  time  of  her  first  preg- 
nancy, another  organ  becoming  then  the  center  of  the  con- 
gestion and  the  seat  of  disorders  of  another  character.  The 
patient  began  by  experiencing  a  sensation  of  pressure 
toward  the  genital  organs;  some  months  after  her  first  con- 
finement, a  heavy  weight  pressing  upon  the  rectum,  swelling 
of  the  haemorrhoids,  greenish  yellow  leucorrhaea,  sometimes 
bloody,  and  discharge  of  pure  blood  by  the  vulva  at  stool. 

Thrilling  pains  in  the  lower  extremities.  Painful  weariness 
in  the  loins,  in  the  nates  ;  very  great  debility  which  rendered 
walking  very  difficult,  often  impossible,  at  the  period  of  the 
menses.  To  these  symptoms,  which  kept  growing  more 
intense,  there  was  added  a  painful  aching  in  the  whole 
hypogastrium ;  it  caused  an  inexpressible  anguish  and  fre- 
quent syncope,  which  ceased  when  the  menses  began  to 
appear ;  soon  these  became  excessive,  accompanied  by 
spasms  in  the  abdomen,  together  with  sharp  lancinations  in 
the  uterus. 

Several  cauterizations  had  been  made,  the  operator  having 
been  induced  to  resort  to  them  (as  he  is  reported  to  have 
said)  by  the  tumefaction  of  the  cervix,  in  which  there  were 
several  deep  fissures.  The  body  of  the  uterus,  more  volu- 
minous than  natural,  was  very  much  inclined  forward,  the 
cervix  resting  upon  the  posterior  wall  of  the  pelvis.  This 
positkm  must,  no  doubt,  have  aggravated  the  pains. 

The  cauterization,  although  often  repeated,  did  but  little 
good.  It  was  given  up,  and  for  several  months  longer  the 
sufferings  were  the  same.  Immediately  after  the  menstrual 
period,  five  centigrammes  of  Murex 4  were  given  in  1 20 
grammes  of  water ;  the  patient  took  a  spoonful  every  morn- 
ing. The  symptoms  perceptibly  diminished  before  the 
ensuing  menstrual  period.  The  latter  was  attended  with 
but  little  suffering,  and  the  flow  was  less  than  usual.  Above 
all,  the  leucorrhcea  was  decidedly  diminished.  A  second 


MUREX   PURPUREA.  379 

dose,  given  in  the  same  way,  as  soon  as  the  flow  had  ceased, 
was  sufficient  to  re-establish  the  health  of  the  patient,  who 
for  the  last  year  has  continued  to  be  well. 

From  these  two  observations  and  others  analogous  to 
them,  one  may  deduce  principles  of  a  useful  application. 
They  will  find  their  place  hereafter. 

RESUME  OF  THE  PATHOGENETIC  SYMPTOMS  OF  MUREX  PURPUREA, 
BY  DR.  PETROZ. 

Head. 

1.  Confusion  of  ideas,  repugnance  to  conversation,  deep 
sadness  in  the  evening ;  first  day. 

2.  Pain  in  the  occiput  toward  midday ;  first  day. 

3.  Headache  on   awaking,  which  disappears  on   rising ; 
first  day. 

4.  During  the  day,  pain  in  the  left  temple,  which  goes 
and  comes. 

5.  Heaviness  of  the  head  from  time  to  time,  which  leaves 
at  intervals  great  clearness  in  the  ideas ;  second  and  third 
day. 

6.  At   the  end  of  the  day,  tightness  behind  the  head, 
which  causes  her  to  raise  the  hand  involuntarily  to  the  seat 
of  the  pain ;  when  the  pain  is  on  the  left  side  she  raises  the 
right  hand,  and  vice  versa.     Desire  to  bend  the  head  back- 
ward ;  this  motion  relieves  the  head  and  neck  ;  second  day. 

7.  The  head  is  heavy  for  short  periods  of  time ;  third  day. 

8.  The  right  cheek  burns  toward  evening  ;  third  day. 

9.  Tightness  of  the  head  behind  the  ears  ;  third  day. 

10.  The  left  cheek  burns  in  the  morning ;  sixth  day. 

11.  Headache  (heaviness)  lasting  one  hour;  sixth  day. 

12.  Pressive  frontal  headache;  seventh  day. 

13.  Confusion  in  the  head,  sleepiness ;  labor  is  irksome; 
eighth  day. 

14.  Pressive  pain  in  the  right  temple  ;  ninth  day. 

15.  Pain  in  the  occiput,  very  acute,  but  of  short  duration  ; 
first  day. 


380  MUREX  PURPUREA. 

1 6.  Head  confused,  heavy  ;  indisposition  to  work  ;  second 
day. 

17.  Buzzing  in  the  ears  and  increased  heaviness  in  the 
head ;  second  day. 

1 8.  Diminution  of  memory,  difficulty  in  finding  words. 

19.  Heaviness  of  the  head  as  when  the  atmosphere  is 
close. 

20.  The  nose  is  cold  all  day  so  that  she  is  much  incom- 
moded thereby ;  third  day. 

Thorax. 

21.  Palpitation  of  the  heart,  throbbing  of  the  arteries  of 
the  neck ;  first  day. 

22.  Pain  in  the  thorax  as  if  broken. 

23.  Incisive  burning  pain  under  the  false  ribs  (left  side), 
and  toward  the  spine  ;  second  day. 

24.  Dry  infrequent  cough,  oppression  ;  second  day. 

25.  The  voice  is  changed,  hoarseness ;  second  day. 

26.  Pain  in  the  mammae ;  third  and  fourth  days. 

27.  Cough  in  the  morning  before  breakfast ;  first  day. 

28.  Wheezing  in  the  chest  in  the  evening  when  breathing; 
seventh  day. 

29.  Severe  pains  in  the  mammas ;  eighth  day. 

30.  Sharp  lancinations  in  the  mammae. 

Stomach. 

31.  Hunger  during  the  day,   in  the  morning;    none  at 
dinner. 

32.  Hunger  the  sixth  day. 

Abdomen. 

33.  Evacuation  difficult ;  second  day. 

34.  Painful  tension  in  the  right  hypochondrium ;  second 
day. 

35.  Colic;    fourth  day.     Colic  in   the  evening;    seventh 
day.  Constipation  which  lasts  five  days  and  more.     Uneasi- 


MUREX  PURPUREA.  381 

ness  in  the  abdomen  like  that  which  is  caused  by  the 
approach  of  the  menses ;  their  appearance  is  retarded  fifteen 
days ;  eighth  day. 

36.  Acute  pain  like  a  sharp  point  in  the  left  side  of  the 
abdomen  extends  and  is  felt  in  different  isolated  spots ;  the 
left  side  of  the  abdomen  remained  painful  the  whole  evening ; 
second  day. 

37.  The  same  symptoms  less  severe;  third  day. 

38.  Pressure   upon    the   anus   like  painful  points;    first 
day. 

Genital  Organs. 

39.  Acute   pain   in  the  right  side   of  the   uterus   which 
crosses  the  body  and  ascends  to  the  left  mamma ;  first  day. 

40.  Sensation  of  dryness  and  of  constriction  in  the  uterus ; 
second  day. 

41.  Sensation   of  weight  and    of   dilation   in   the   labia 
majora ;  seventh  day. 

42.  Pain  as  if  wounded  by  a  cutting  instrument  in  the 
uterus ;  seventh  day. 

43.  In  the  evening  (third  day),  two  violent  lancinations, 
lasting  one  minute,  in  the  left  side  of  the  abdomen  in  an 
upward  direction. 

44.  Excitement  of  the  genital  organs ;  desire  so  violent 
as  to  fatigue  the  reason. 

45.  Greenish  thick  leucorrhcea;  seventh  day.     The  same 
(third  day)  diminished  but  thicker ;  eighth  day. 

46.  The  leucorrhcea  becomes  bloody ;  ninth  day. 

47.  Return  of  bloody  discharge  from  the  vulva  on  going 
to   stool    (fourth   day)   a   part   of   the   day ;    it  ceases  and 
re- appears. 

48.  Venereal  desire  renewed  by  the  slightest  touch ;  sec- 
ond day. 

49.  Heaviness  in  the  vagina  during  the  existence  of  the 
pain  in  the  abdomen. 

50.  Throbbings  in  the  uterus ;  fifth  day. 


382  MUREX   PURPUREA. 

51.  Watery  leucorrhoea  lasting  only  a  half  day;  second 
day. 

Urinary  Organs. 

52.  Urine  with  white  sediment.      Discharge  of  a   small 
quantity  of  bloody  mucus  after  the  passage  of  urine ;  fifth 
day. 

53.  Frequent  call  to  urinate  during  the  day;  second  day. 

54.  When  urinating  slight  bloody  discharge ;  eighth  day. 

55.  Frequent   need   to  urinate   during   the    night,  urine 
colorless ;  third  day. 

56.  Urine  fcetid  ;  the  odor  much  resembling  that  of  Vale- 
rian ;  this  odor  soon  diminishes  and  disappears ;  third  day. 

Trunk. 

57-  Pain  in  the  loins.     Sensation  of  burning,  of  excoria- 
tion ;  first  day. 

58.  Pain  in  the  loins;  eighth  day. 

59.  Pain  in  the  loins  when  lying  down,  pain  in  the  hips 
(second  to  third  day)  especially  in  bed. 

60.  Pain  around  the  pelvis ;  third  day. 

Extremities. 

6 1.  Extreme   feebleness    in    the   voluntary   movements. 
The  limbs  give  way  and  there  is  irresistible  desire  to  remain 
seated ;  first  day. 

62.  Pain  in  the  knees ;  first  day. 

63.  Heat  in  the  hands ;  first  day. 

64.  Pain  in  the  arms  below  the  elbows  (first  day) ;  simple 
pain  in  the  legs  from  time  to  time ;  third  day. 

65.  Pains  of  very  great  weariness  in  the  thighs   (eighth 
day);  pain   of  contusion  in   the    front  and  middle    of  the 
thighs. 

66.  Extreme  lassitude,  pains  in  the  legs  and  knees ;  ninth 
day. 

67.  Sharp  heat  in  the  anterior  part  of  the  thighs ;  second 
day. 


MUREX  PURPUREA.  383 

68.  On  rising,  acute  pain  in  the  middle  anterior  portion 
of  the  left  thigh ;  she  cannot  bear  to  have  it  touched ;  it 
lasts  the  whole  day ;  fifth  day. 

69.  Sensation  of  throbbing  in  the  anterior  part  of  the 
thigh. 

Sleep. 

70.  Drowsiness ;  first  day. 

71.  Drowsiness  and  sadness ;  second  day. 

72.  At  9  P.  M.  great  desire  to  sleep. 

73.  Sleep  with  troublesome  dreams;  fleeing  from  a  tur- 
bulent ocean  she  found  herself  in  a  plain  full  of  water ;  third 
day. 

74.  Troublesome    dreams    (fourth   day) ;    ditto    (seventh 
day),  waking  with  fright. 

75.  Sleep  interrupted  by  pains  altogether  similar  to  those 
which    sometimes    accompany    the    menses    (third    day) ; 
anguish. 

76.  Wakes  with  a  start  and  a  violent  desire  to  urinate ; 
urine  abundant. 

General  Symptoms. 

77.  Excessive  fatigue ;  first  day. 

78.  Sensation  of  anguish  during  the  day,  feeling  of  fear, 
of  indefinite    fright;    for   several   days   the   sufferings   are 
greater  when  sitting  than  when  walking ;  when  walking  they 
cease,  and  re-appear  on  sitting  down. 

79.  Sensation  of  dryness  in  the  skin,  as  if  it  would  crack. 

PROVINGS  ON  PATIENTS,  by  M.  de  B.,  furnished  by  Dr. 
C.  Hering. 

January  I2th,  1852.  Taken  by  a  lady,  aged  38  years,  of 
sanguine-nervous  temperament.  She  has  been  ill  eight 
years  of  prolapsus  uteri.  For  more  than  a  year  she  was 
unable  to  stand.  For  several  years  she  has  suffered  excru- 
ciating pain.  Her  mind  is  in  a  very  gloomy  state. 


384  MUREX   PURPUREA. 

She  has  been  under  my  care  about  three  years,  and  has 
constantly  but  slowly  regained  health.  She  can  now  ride 
about  ten  miles  and  rest  in  an  hour  afterward;  can  sew 
about  eight  hours  in  a  day,  but  must  rest  frequently,  and 
has  never  passed  a  day  without  lying  down.  Her  mind  has 
gradually  recovered  its  cheerfulness,  and  she  has  been  for 
several  months  desirous  of  society,  which  even  one  year 
since  she  could  not  at  all  endure. 

I  directed  her  not  to  take  any  other  medicine  for  ten  days 
before  the  Murex.  She  has  taken  three  doses  at  intervals 
of  ten  days.  The  symptoms  have  been  the  same  each  time, 
only  much  more  intense  than  the  first  dose.  I  gave  her  the 
two  hundredth  dilution ;  she  took  it  in  the  morning  as  soon 
as  she  had  risen.  For  the  first  four  hours  she  felt  nothing. 
Then  she  felt  a  debility  of  the  entire  muscular  system ;  a 
sinking  of  the  stomach ;  an  enlargement  of  the  bowels ;  a 
distinct  feeling  of  the  womb  ;  and  great  sensitiveness  of  the 
bowels,  with  sharp  pain  running  up  from  the  groin  to  the 
socket  of  the  right  hip.  A  sensation  as  of  the  creeping  of  a 
snake  over  the  entire  region  of  the  short  ribs,  upon  the  left 
side ;  great  depression  of  spirits ;  it  seemed  to  her  that  she 
was  hopelessly  ill.  She  was  obliged  to  go  to  bed  and  lie 
there.  These  symptoms  continued  for  nearly  a  week,  with- 
out abatement,  and  at  the  end  of  a  week  she  felt  about  as 
usual,  except  that  she  was  rather  gloomy  in  mind.  The 
second  and  third  doses  produced  the  same  symptoms,  but 
less  intense. 

No.  2.  A  lady,  aged  about  30  years,  of  sanguine-nervous 
temperament,  had  been  for  five  years  subject  almost  con- 
stantly to  pain  in  her  right  hip,  and  a  feeling  of  sinking  at 
the  stomach,  which  incapacitated  her  for  sewing  or  knitting. 
She  took  but  one  dose  and  said,  "  It  made  me  miserable.  I 
was  so  low-spirited  that  I  gave  up  everything.  I  had  no 
strength  left.  My  stomach  seemed  gone,  and  an  intolerable 
creeping  pain  in  my  right  hip  kept  me  from  getting  any 
ease  in  any  position."  I  ought  to  add  that  this  lady  had 


MUREX   PURPUREA.  38$ 

been  so  well  for  the  last  eight  months  that  I  had  not  been  in 
attendance  upon  her.  The  duration  of  the  effect  of  the 
medicine  in  her  case  was  about  five  days. 

No.  3.  A  lady,  aged  23  years,  of  sanguine-nervous  tem- 
perament. I  had  treated  her  during  the  year  past  for  pro- 
lapsus uteri,  with  the  ordinary  debility  in  the  lumbar  region, 
palpitation  of  the  heart,  sinking  at  the  stomach,  etc.,  that 
usually  accompany  that  affection.  She  recovered  rapidly 
and  seemed  to  be  in  sound  health  for  the  last  six  months. 
She  took  three  doses  of  Murex  at  intervals  of  ten  days,  and 
perceived  no  effect  whatever. 

The  following  case,  wrnch  occurred  under  my  own  observa- 
tion, presents  some  points  of  interest : 

Mrs.  C.,  aged  28  years.  Seven  years  ago,  about  four 
months  after  her  marriage,  she  had  a  miscarriage  and  subse- 
quently a  prolapsus  uteri  and  so-called  ulceration  of  the 
cervix,  for  which  she  was  under  local  (allopathic)  treatment 
for  a  period  of  eighteen  months.  Three  years  ago,  after 
unusual  exercise  under  circumstances  of  great  emotional 
excitement,  she  had  a  recurrence  of  the  prolapsus,  under 
which  she  suffered  for  some  time. 

June  3Oth.     After  taking  unusually  violent  exercise,  the' 
patient  was  suddenly  subjected  to  terrible  mental  excite- 
ment. 

July  1st.  She  applied  for  medical  treatment.  She  has 
bearing  down  sensations  ;  a  feeling  as  if  the  internal  genitals 
were  being  pushed  out,  with  great  nausea  and  faintness,  and 
a  peculiarly  distressed  sinking  sensation  in  the  epigastrium. 
A  vaginal  examination  reveals  a  slight  prolapsus,  a  very  long 
cervix,  but  no  ulcerations.  There  was  utter  loss  of  appetite 
and  great  despondency. 

In  consequence  of  the  great  faintness  and  "  sinking  at  the 
stomach"  (which,  Dr.  Lippe  says,  is  a  strong  characteristic 
of  Murex),  in  addition  to  the  other  symptoms  which  indi- 
cated  this   remedy,   Murex   purpurea6   was    prescribed,    a 
26 


386  MUREX   PURPUREA. 

powder  every  four  hours  (no  higher  potency  being  at 
hand). 

July  3d.  The  patient  reports  that  in  fifteen  minutes  after 
taking  the  first  powder,  she  felt  very  hungry  and  ate  some- 
thing. After  the  second  powder,  a  still  greater  degree  of 
hunger ;  she  again  took  food.  After  the  third  powder,  she 
expressed  herself  as  "half  starved"  and  had  to  have  a 
hearty  meal  prepared,  which  she  ate.  She  slept  well. 

July  4th.  After  the  first  powder,  this  morning,  the  same 
sensation  of  hunger,  though  in  a  less  degree  than  yesterday. 
In  the  region  of  the  uterus  she  felt  much  better. 

July  6th.  Has  gained  in  every  way.  Felt  quite  well  as 
regards  the  uterine  symptoms  and  the  sinking  at  the 
stomach,  until  this  evening,  having  been  frightened  by  a 
dog,  she  fainted.  This  brought  back  the  symptoms  of  July 
1st,  which,  however,  were  soon  relieved  by  Murex,  and 
have  not  since  returned. 


PLATINA.1 


Preparations  for  medicinal  use.  Chemically  pure  Platina, 
which  is  soft,  and  may  be  cut  with  a  knife,  is  dissolved  in 
aqua  regia  by  the  aid  of  heat,  the  resultant  golden  yellow 
solution  diluted  to  a  sufficient  extent,  and  a  clean  smooth  rod 
of  steel  suspended  in  it,  on  which  the  Platina  precipitates, 
forming  a  crystalline  coating.  This  precipitate,  which  may 
be  easily  rubbed  off  the  rod,  is  several  times  washed  in 
distilled  water  (until  free  from  acid),  and  then  well  dried 
between  layers  of  bibulous  paper.  One  grain  of  this  pre- 
cipitate, triturated  for  two  hours  with  ninety-nine  grains  of 
milk  sugar,  forms  the  first  centesimal  trituration  of  Platina. 
The  further  dynamizations  are  prepared  in  the  usual  manner. 

Literature.  Stapf  and  Gross,  Archiv.  i.,  I :  Hahnemann, 
Chronic  Diseases,  v. 

Action.  Platina  develops  its  effects  as  well  in  the  province 
of  the  brain  as  in  that  of  the  spinal  cord,  and  of  the  great 
nervous  branches  proceeding  from  it.  The  great  splanchnic 
nerves,  distributed  in  the  abdomen,  and,  in  particular,  the 
nerves  of  the  uterine  system  given  off  from  the  hypogastric 
plexus,  are  especially  affected  by  Platina.  From  this 
specific  action,  no  inconsiderable  number  of  symptoms  seem 
to  result  which  are  quite  peculiar  to  this  remedy,  as  well 
moral  affections  as  many  aches  and  pains.  Hence  this 
remedy,  as  will  be  seen,  is  especially  appropriate  for  diseases 
of  females,  such  as  we  often  meet  in  women  and  maidens. 
Whether  Platina  is  suitable  only  for  irritable,  excitable 
females,  with  predominant  activity  of  the  sexual  functions,  as 
the  majority  of  writers  assume,  and  among  them  Stapf  and 

1  Adapted  from  the  German  of  Dr.  Veit  Meyer. 


388  PLATINA. 

Gross,  the  provers  of  it,  who,  by  the  way,  made  their 
provings  on  a  very  excitable  'young  woman,  I  shall  leave 
undetermined.  For  myself,  I  have  had  frequent  occasion  to 
administer  Platina,  and  have  obtained  the  very  best  curative 
results  in  appropriate  diseased  conditions,  occurring  in 
phlegmatic  women  of  lax  fiber.  This  observation,  too, 
appears  to  me  to  stand  by  no  means  in  opposition  to  the 
totality  of  the  Platina  symptoms,  but  rather  to  accord  most 
clearly  with  them.  For,  on  a  critical  review  of  what  has 
been  made  known  concerning  the  action  of  the  remedy,  we 
find  that  all  or  by  far  the  greater  part  of  its  symptoms  bear 
the  character  9f  depression,  but  not  that  of  erethism.  A  lack 
of  energy,  a  lack  of  electric  tension  of  the  nerves,  if  I  may  so 
express  myself,  seems  to  me  more  clearly  manifest  in  Platina 
than  in  any  other  remedy.  And  although  we  find,  it  is  true, 
isolated  phenomena  which  seem  to  indicate  a  contrary  action, 
yet  we  regard  these  only  as  reflex  or  alternate  effects ;  and, 
indeed,  they  occur  in  so  isolated  a  manner  as  almost  to 
disappear  before  the  mass  of  symptoms  which  justify  the 
view  I  have  taken.  It  may  be  that  a  farther  proving  of  this 
drug,  which,  by  the  way,  is  very  desirable,  would  disprove 
our  assumption  :  for  the  present,  however,  we  can  only  hold 
to  that  proving  of  which  we  are  already  in  possession.  In 
this  proving  we  find,  in  every  system  on  which  Platina 
acts,  the  stamp  of  relaxation,  of  diminished  energy,  of 
depression,  of  torpor.  As  well  in  the  psychical  and  sensuous, 
as  in  the  sensitive,  motor,  and  vegetative  nervous  systems, 
we  see  this  character  manifested  by  the  trembling,  the 
sensations  of  chilliness,  the  coldness  and  paralysis  which  are 
so  frequently  present.  The  assertion  will  be  demonstrated 
when  we  come  to  consider  the  passive  and  negative  relation 
of  Platina  to  the  sympathetic  system  as  the  regulator  of 
the  entire  vascular  system  in  the  human  body.  But  Platina 
presents  no  phenomena  of  hyperaemia,  no  independent  or 
primary  inflammation,  no  strikingly  accelerated  circulation. 
Hence,  we  find  no  alterations  in  the  pulse,  such  as  the 


PLATINA.  389 

learned  and  careful  provers  would  certainly  have  signal- 
ized had  they  occurred  during  the  proving. 

We  have  gained,  then,  several  general  positions  with 
reference  to  the  sphere  of  action  of  Platina. 

1.  A    negative  position,  viz.  :  that  it   does  not  directly 
affect  the  blood  life. 

2.  That  it  exerts  its  greatest  power  upon  the  brain  and 
spinal  cord,  and  especially  in  several  particular  provinces  of 
these  nervous  centers ;  and,  finally, 

3.  That  it  depotentizes  and  depresses  the  nervous  life. 
Let  us  now  seek  to  determine  these  characteristic  qualities 

in  the  individual  phenomena  of  the  drug,  and  inquire,  first, 
how  and  how  far  the  action  of  Platina  is  manifest  on  the 
brain  and  spinal  cord,  and  what  changes  this  drug  is  able  to 
effect  in  the  individual  spheres  of  these  central  organs.  But, 
in  giving  a  true  picture  of  the  action  of  Platina,  I  cannot 
be  expected  to  adhere  closely  to  the  organic  order  of  the 
individual  parts  of  the  nervous  system.  I  shall  rather  bring 
first  to  view  those  phenomena  which  stand  forth  most 
strikingly  among  the  symptoms  of  Platina,  and  arrange  the 
others  subsequently  in  the  order  of  their  importance.  Thus, 
then,  in  surveying  the  isolated  Platina  symptoms,  we 
encounter  a  pathological  picture  which  we  have  not  unfre- 
quently  occasion  to  meet  in  women — I  mean  hysteria. 

In  the  delineation  of  this  picture,  we  begin  by  the  recital 
of  those  symptoms  which  relate  to  the  proximate  cause  of 
this  affection : 

I.    DISTURBANCES   IN   THE   UTERINE   SYSTEM. 

The  following  symptoms  clearly  indicate  this : 

In  both  groins,  painful  drawing,  as  if  the  menses  were 
about  to  set  in. 

Pressing  in  the  hypogastrium,  with  a  feeling  of  weakness, 
as  before  the  menses. 

Painful   pressing   down   toward   the   genitals,  as    if  the 


390  PLATINA. 

menses  were  commencing ;  sometimes  with  tenesmus,  draw- 
ing through  the  groins  over  the  hips  to  the  sacrum,  where 
the  pain  continues  longer. 

Painful  sensibility  and  constant  pressure  in  the  pubic 
region  and  in  the  genitals,  with  almost  constant  internal 
chilliness  and  external  objective  coldness  (except  in  the 
face). 

In  the  evening,  in  bed,  the  painful  pressure  as  if  from  the 
menses  commencing  ceases  immediately,  but  is  felt  again  in 
the  morning,  after  rising. 

Cutting  in  the  hypogastrium,  as  if  before  the  menses,  with 
drawing  headache. 

On  the  second  day  of  the  menses,  cutting  in  the  abdo- 
men ;  then,  pressing  down  in  the  groin,  alternating  with 
pressure  in  the  genitals,  with  increased  congestion  and  dis- 
charge of  blood. 

Pressing  in  the  abdomen,  and  depression  of  spirits,  with 
copious  menstrual  flow. 

Menses  six  days  too  early,  with  diarrhoea. 

Menses  fourteen  days  too  early,  and  very  copious. 

Menses  six  days* too  early,  and  lasting  eight  days,  with 
drawing  pain  in  the  abdomen  the  first  day. 

The  first  day  of  the  menses,  discharge  of  much  clotted 
blood.  Voluptuous  tingling  in  the  genitals  and  in  the  abdo- 
men, with  oppressive  anxiety  and  palpitation;  thereupon, 
painful  pressure  low  in  the  genitals,  with  relaxed  feeling  and 
sticking  in  the  sinciput. 

Leucorrhoea  like  white  of  egg,  without  sensation,  only  by 
day,  sometimes  after  urinating,  sometimes  after  rising  from 
her  seat. 

If  we  consider  these  symptoms  connectedly,  we  see  that 
the  disturbances  excited  in  the  uterine  system  by  Platina 
consist  chiefly  in  certain  spasmodic  affections  and  pains,  and 
in  the  too  early  appearance  of  the  menstrual  discharge. 
This  anticipation  of  the  menses,  however,  does  not  result 
from  an  abnormal,  congestive  overloading  of  the  uterus  with 


PLATINA.  391 

blood,  as  we  have  heretofore  seen  to  be  the  case  with 
Aconite,  and  as  others  have  observed  of  Pulsatilla  and 
Crocus,  in  the  case  of  which  remedies  the  clearly  marked 
alternations  in  the  character  of  the  blood  discharged,  in 
addition  to  many  other  phenomena  indicative  of  hyperaemia, 
are  evidence  of  such  a  condition.  The  too  early  and  too 
long-continued  menstruation  of  Platina  depend  not  so  much 
on  sanguineous  congestion  as,  rather,  on  atony  of  the  nerves 
and  vessels  of  the  uterus,  whereby  a  condition  resembling 
anaemia  is  induced,  which  is  indicated  in  the  symptoms 
"pale  and  sunken  face;  pale,  wretched  aspect  for  several 
days."  (The  heat  and  redness  of  face  are  alternate  effects.) 
This  atonic  condition  is  evidenced,  too,  by  the  already  men- 
tioned symptom,  "  painful  sensibility,  etc.,  with  almost  con- 
stant internal  chilliness  and  external  objective  coldness;" 
since,  indeed,  as  we  shall  soon  see,  chilliness  and  coldness 
are  peculiar  to  Platina. 

Proceeding  with  the  further  delineation  of  the  Platina 
hysteria,  to  which  we  have  a  good  clue  in  the  symptoms, 
"  pressing  in  abdomen,  with  ill-humor,  attending  the  copious 
menses,"  we  shall  see  what  is  the  nature  of  the  psychical 
affection. 

II.      DISTURBANCES  IN  THE   PSYCHICAL  SPHERE   OF 
THE  NERVOUS  SYSTEM. 

Depression,  despondency,  taciturnity. 

She  thinks  she  is  neglected,  and  stands  alone  in  the 
world. 

Anxiety,  with  flushes  of  heat  and  trembling  of  the  hands. 

Great  anxiety,  with  violent  palpitation  of  the  heart,  when- 
ever she  would  speak  in  company,  so  that  speaking  becomes 
irksome  to  her. 

Anxiety  as  though  she  should  die  or  lose  consciousness, 
with  trembling  in  every  limb,  oppressed  breathing,  and 
violent  palpitation  of  the  heart. 


392  PLATINA. 

Anxiety  in  region  of  the  heart,  and  apprehensiveness,  as 
if  she  must  soon  die,  with  disposition  to  weep,  and  actual 
weeping. 

Great  restlessness  of  disposition, — she  can  rest  quietly 
nowhere,  —  with  melancholy  which  renders  even  the  most 
joyous  objects  disagreeable  to  her.  She  thinks  she  is  not 
fit  for  the  world,  is  tired  of  life,  but  has  the  greatest  dread 
of  death,  which  she  believes  is  at  hand. 

Morose  and  ill-content. 

Discontent  with  the  whole  world ;  everything  is  a  con- 
straint; with  inclination  to  weep. 

Sad  and  morose,  she  sits  alone,  without  speaking,  and 
cannot  resist  sleep ;  then,  inconsolable  weeping,  especially 
when  spoken  to. 

Silence  and  involuntary  weeping,  even  after  being 
addressed  in  the  most  friendly  manner,  so  that  she  is  angry 
at  herself  for  it. 

Disposition  to  weep,  and  weeping  after  receiving  a  mild 
reproof. 

Ill-humored,  and  disposed  to  weep ;  often  obliged  to 
weep  involuntarily,  which  relieves  her. 

Disposition  to  weep,  and  melancholy ;  worse  in  her  cham- 
ber, better  in  the  open  air. 

Sad  and  morose  the  first  morning ;  the  next,  indescribably 
happy,  especially  in  the  open  air,  so  that  she  could  have 
embraced  everything,  and  made  merry  over  the  saddest 
objects. 

Very  lachrymose,  and  easily  touched  by  causes  quite  too 
trivial. 

Very  earnest  and  silent  the  first  day;  the  next  day, 
everything  presents  itself  to  her  in  a  ridiculous  aspect 

Chilliness  and  shuddering,  mingled  with  fugitive  heat,  with 
ill-humored  taciturnity  in  the  open  air;  later,  pleasant 
warmth  throughout  whole  body,  with  return  of  cheerfulness. 

Great  cheerfulness,  so  that  she  could  dance,  a  half  hour 
after  weeping. 


PLATINA.  393 

Great  cheerfulness  for  two  days ;  everything  seems  joyous, 
she  could  laugh  at  the  saddest  object ;  third  day,  great  melan- 
choly in  the  morning  and  evening,  with  weeping,  even  over 
joyous  or  ridiculous  objects,  and  also  when  spoken  to. 

Involuntary  disposition  to  whistle  and  sing. 

Very  fretful  and  irritable,  even  at  things  and  words  that 
are  quite  innocent,  so  that  she  could  sometimes  strike  at 
herself  and  her  friends. 

No  remedy  gives  us  so  striking  a  picture  of  the  hysteric 
perversion  of  the  disposition  as  Platina.  The  depression 
and  anxiety  which  often  increase  in  intensity,  even  up  to 
actual  apprehension  of  death,  so  that,  as  I  have  sometimes 
experienced  at  the  bedside,  patients  make  every  provision 
and  arrangement  for  the  disposition  of  their  affairs  after 
death,  are  characteristic  indications  of  hysteria  as  well  as  of 
the  Platina  disease.  Platina,  however,  is  most  especially 
appropriate  in  that  form  of  hysteria  in  which  the  disposition 
to  weep,  and  the  fear  of  death,  which  is  thought  to  be  at 
hand,  accompany  all  the  other  morbid  phenomena.  I 
remember  a  case  in  which  a  mother  was  compelled,  on 
account  of  debility,  to  wean  her  child  earlier  than  she  had 
wished  to  do  so.  Several  days  after  I  was  called  to  her,  and 
on  entering  the  chamber  found  her  friends  wringing  their 
hands  as  they  surrounded  her  bed;  for  the  patient,  who 
never  ceased  weeping,  spoke  amid  anxiety  and  apprehension, 
of  nothing  but  her  death,  and  how  fearful  it  was  to  have  to 
die  so  young.  She  had  already  made  all  testamentary 
arrangements.  The  most  careful  investigation  could  discover 
nothing  morbid  in  the  mammae,  which  were  still  distended 
with  milk,  but  not  hard;  even  the  pulse  had  not  varied 
from  its  normal  condition.  My  exhortation  to  dismiss  these 
thoughts  of  death,  for  which  there  existed,  I  assured  my 
patient,  not.  the  slightest  ground,  was  gently  rejected,  as  was 
also  at  first  the  medicine  I  ordered  for  her ;  and  she  told  me 
with  tears,  that  she  had  merely  sent  for  me  that  she  might 
see  me  once  again  before  her  death.  Finally,  I  succeeded 


394  PLATINA. 

in  getting  her  to  take  a  grain  of  the  third  trituration  of 
Platina.  When  I  saw  the  patient  again  in  the  evening,  the 
fear  of  death  and  the  weeping  had  vanished,  and  the  depres- 
sion which  still  remained  yielded  the  following  day  to 
her  accustomed  cheerfulness.  She  became  healthy,  and 
remained  so. 

Moreover,  we  find  in  the  just  enumerated  moral  symptoms 
of  Platina,  the  alternations  of  cheerfulness  and  sadness,  of 
laughing  and  weeping,  which  are  peculiar  to  hysteria, — 
just  as,  generally  in  nature,  exaltation  so  often  follows 
depression  or  alternates  with  it. 

The  same  condition  of  depression  we  observe,  too,  in  the 
perceptive  faculty,  as  is  shown  by  the  following  symptoms : 

Illusion  of  fancy  upon  entering  the  room  after  a  walk  of 
one  hour,  as  if  everything  around  her  were  very  small,  and 
everybody  inferior  to  her,  both  in  regard  to  body  and  mind, 
and  as  if  she  herself  were  tall  and  elevated;  the  room 
appears  gloomy  and  disagreeable  to  her,  accompanied  with 
slight  anguish,  sad  and  vexed  mood,  vertigo,  and  uncomfort- 
able feeling  in  the  midst  of  a  society  that  she  was  generally  fond 
of;  all  this  passes  off  in  the  open  air  when  the  sun  shines. 
Looking  down  contemptuously  and  pitifully  upon  people, 
whom  at  other  times  she  respects,  against  her  will,  in 
paroxysms.  During  her  contemptuous  turns  she  is  suddenly 
attacked  with  canine  hunger,  and  eats  in  a  greedy,  hasty, 
manner ;  when  the  regular  meal-time  arrived  she  had  lost  all 
her  appetite.  Proud  feeling.  Cold,  absent,  indifferent  in 
company  of  friends  ;  she  only  answers  when  she  must,  and 
is  only  half  conscious  of  what  she  says;  after  having 
answered,  she  reflects  whether  her  answer  had  been  suitable; 
she  is  constantly  absent  without  knowing  where  her  thoughts 
are  roaming.  She  imagines  she  does  not  belong  to  her 
family ;  after  a  short  absence  all  things  appear  changed 
to  her ;  absence  of  mind ;  she  listens  to  conversations 
around  her,  but  after  they  are  terminated  she  has  forgotten 
what  she  heard.  Great  absence  of  mind ;  she  hears  not 


PLATINA.  395 

what  is  said  to  her,  even  when  addressed  with  great  emphasis. 
Not  disposed  to  intellectual  labor ;  dull,  stretching  sensation, 
as  of  a  board  before  the  forehead,  passing  attacks  of  vertigo 
in  quick  succession,  in  the  evening  when  standing,  as  if  she 
would  lose  her  consciousness ;  violent  vertigo,  she  dares  not 
move  her  eyes  ;  more  in  day-time  than  at  night ;  generally 
when  she  is  attacked  with  palpitation  of  the  heart. 

The  characteristic  feature  of  these  Platina  illusions  is  the 
proud  exaltation  of  one's  self  above  other  persons,  who  are 
regarded  as  contemptible.  This  circumstance  also  has  its 
origin  in  a  depressed  moral  activity,  as  is  shown  by  the 
related  symptoms,  "  the  chamber  seems  gloomy  and  un- 
pleasant," "anxious  apprehension,"  "ill-humor,  vertigo,  and 
discomfort,'.'  etc.,  and  the  "alleviation  in  the  open  air."  Hence, 
too,  Stapf  and  Gross  recommended  Platina  as  "a  very  welcome 
specific  remedy  for  a  not  infrequent  kind  of  melancholy." 

The  sleep,  too,  gives  a  clear  indication  of  disturbance  in 
the  psychic  nervous  system.  In  this  relation  we  are  to  con- 
sider the  following  symptoms : 

Excessive  weakness  and  drowsiness  in  the  evening ;  falls 
asleep  after  midnight,  with  tearing  in  the  ball  of  the  toe  ;  she 
wakes  in  the  night  in  a  sort  of  stupor,  and  is  unable  to  col- 
lect her  senses;  wakes  about  midnight;  ideas  which  she  is 
unable  to  repel  crowding  upon  her  mind,  no  sleep  until 
morning ;  anxious  dreams,  and  gloomy  thoughts,  and  sad 
visions  when  waking  suddenly ;  anxious,  confused  dreams  of 
war  and  bloodshed.  She  dreams  of  fires,  wants  to  go  there, 
but  cannot  get  ready,  with  her  preparations  of  toilet,  etc. 
He  wakes  in  the  morning  with  a  peevish  and  anxious  mood 
as  if  he  had  suffered  injury  during  his  sleep. 

I  might  continue  to  describe  hysteria  in  the  words  of  the 
Platina  symptoms ;  for  many  more  alterations  of  functions 
induced  by  this  remedy  might  easily  be  made  to  contribute 
to  the  completion  of  the  picture.  I  shall  mention,  however, 
in  this  relation,  only  the  digestive  disturbances,  the  spasmodic 
affections,  and  the  pains  induced  by  Platina.  But  I  fear  to 


396  PLATINA. 

lead,  by  this  course,  to  the  erroneous  supposition  that  all  the 
other  phenomena  of  Platina  belong  also  to  hysteria,  and 
thus  to  the  false  conclusion  that  Platina  is  only  and  exclu- 
sively a  remedy  for  hysteria ;  whereas,  on  the  one  hand, 
not  every  form  of  hysteria  finds  its  remedy  in  Platina,  and 
on  the  other,  Platina  is  a  remedy  for  several  other  morbid  con- 
ditions, not  only  of  women,  but  also  of  men.  To  guard  against 
this  error,  I  must  forbear  to  cite  further  the  Platina  symp- 
toms resembling  hysteria,  but  would  not  wish  to  deter  others 
from  studying  and  estimating  their  relations  and  correspond- 
ence. First,  however,  I  must  call  attention  to  a  few  other 
symptoms  of  Platina,  nearly  related  to  hysteria,  less 
important  than  those  already  cited,  but  still  characteristic. 
It  not  unfrequently  happens  in  hysteria,  that  a  feeling  of 
indescribable  anxiety,  with  respiratory  embarrassment,  or 
a  spasmodic  constriction  of  the  oesophagus,  is  experienced. 
This  condition,  generally  denominated  "hysteric  asthma," 
is  depicted  in  the  following  symptoms  of  Platina : 

Sudden  arrest  of  breathing  in  the  throat,  as  takes  place 
when  walking  against  the  wind.  Oppressed  breathing,  with 
warm  rising  from  the  pit  of  the  stomach  to  the  pit  of  the 
throat;  she  has  to  take  deep  breath;  accompanied  with  a 
hoarse  voice,  going  off  again  with  the  oppression.  Impeded 
respiration  from  weakness  of  the  chest;  deep  breathing,  as  if 
a  load  were  oppressing  the  chest ;  frequent  deep  breathing 
without  oppression  of  the  chest;  asthma,  as  if  laced  too 
tightly,  with  heavy,  slow  breathing. 

Another  trouble  frequently  attendant  on  hysteria  is  the 
so-called  clavus  hystericus,  a  peculiar,  tense,  pressing, 
squeezing  headache,  appearing  in  paroxysms,  and  confined 
to  a  small  spot. 

The  following  symptoms  may  be  referred  to  this  con- 
dition :  cramp-pain  in  the  right  temple  in  the  afternoon ; 
cramp-pain  in  the  forehead,  as  if  between  screws;  cramp- 
like  tension  in  the  temples,  as  if  between  screws ;  com- 
pression in  the  forehead,  in  paroxysms;  sudden  and  short 


PLATINA. 


397 


pressing  from  without,  inward  in  the  vertex ;  pressure  under 
the  right  frontal  eminence,  increasing  and  decreasing  in 
paroxysms;  sudden  attack  of  contusive  pain  in  a  small  spot 
of  the  left  parietal  bone ;  dull  pressure  in  the  right  parietal 
bone,  as  of  a  plug  being  lodged  in  it ;  violent  boring  in  the 
center  of  the  forehead,  decreasing  gradually,  and  finally 
disappearing. 

Let  us  now  leave  the  subject  of  hysteria,  and  consider  the 
farther  action  of  Platina  on  the  healthy  body  ;  and,  first : 

III.      THE   DISTURBANCES    IN    THE  VEGETATIVE 
NERVOUS     SYSTEM. 

Viscid  and  slimy  in  the  mouth  the  whole  day,  especially 
after  a  meal,  also  in  the  morning,  with  very  bad  humor; 
occasional  conflux  of  water  in  the  mouth ;  sensation  in  the 
upper  part  of  the  tongue  as  if  burnt,  increased  by  rubbing 
the  teeth  over  it ;  scraping  sensation  in  the  throat,  as  if  raw, 
in  the  evening  after  lying  down,  and  on  the  day  following, 
sometimes  accompanied  with  an  irritation  resulting  in  short 
cough ;  sweet  taste  on  the  tip  of  the  tongue ;  no  appetite ; 
she  relishes  the  first  mouthfuls,  but  she  is  soon  replete;  she  is 
speedily  satisfied  at  supper  owing  to  great  sadness,  later  she 
eats;  pinching  in  the  umbilical  region  after  a  meal,  as  if 
diarrhoea  would  come  on  ;  empty  eructations  in  the  morning; 
loud  eructations  in  the  morning,  and  after  dinner;  sudden 
gulping  up  of  a  bitter  sour  fluid,  inducing  cough  and  a  scrap- 
ing sensation  in  the  throat ;  nauseous  feeling  in  the  region  of 
the  stomach ;  qualmishness  in  the  region  of  the  stomach  in 
the  morning ;  continual  nausea,  with  great  faintness,  anxious- 
ness,  and  a  trembling  sensation  through  the  whole  body  in 
the  forenoon;  desire  to  vomit,  without  vomiting,  coming 
and  going  increasingly  accompanied  with  great  qualmish- 
ness and  uneasiness  in  the  limbs. 

Stomach.  Pressure  in  the  pit  of  the  stomach,  also  when 
touching  it ;  pressure  in  the  pit  of  the  stomach  after  eating 


398  PLATINA. 

bread  and  butter,  as  if  he  had  eaten  something  that  had  not 
been  digested;  repletion  in  the  stomach  and  abdomen,  as  if 
overloaded,  in  the  morning  before  breakfast,  with  a  good 
deal  of  empty  eructation ;  distension  of  the  pit  of  the 
stomach  and  the  stomach  itself,  with  a  scratching  and  tear- 
ing sensation  in  the  stomach ;  drawing  pain,  with  pressure 
under  the  pit  of  the  stomach,  as  if  occasioned  by  a  strain  ; 
contractive  pain  around  the  pit  of  the  stomach,  as  if  she  had 
laced  herself  too  tightly,  with  a  suffocative  sensation  ;  pain- 
ful sensation  around  the  pit  of  the  stomach,  as  if  she  had 
laced  herself  too  tightly,  with  sensation  as  if  it  would  go 
off  by  eating;  oppression  around  the  pit  of  the  stomach, 
independent  of  breathing;  pinching  in  the  region  of  the 
scrobiculus  cordis,  and  shortly  after  sensation  as  if  press- 
ing into  the  hypogastrium,  as  if  flatulence  were  crowding 
down ;  the  sensation  went  off  when  a  desire  for  emission 
of  flatulence  made  its  appearance,  which,  however,  took 
place  with  great  difficulty,  the  sensation  in  the  groin 
returned  all  the  time,  with  distension  of  the  abdomen ; 
creeping  in  the  pit  of  the  stomach,  rising  into  the  throat,  as 
if  she  had  swallowed  little  particles  of  a  feather,  vomiturition 
ensued ;  itching  in  the  region  of  the  stomach  going  off  by 
friction ;  fermenting  sensation  in  the  region  of  the  stomach ; 
dull  beating  as  with  a  hammer  in  and  near  the  pit  of  the 
stomach,  in  the  region  of  one  of  the  cartilages  of  the  ribs 
(immediately) ;  violent  stitches  on  the  right  side  near  the  pit 
of  the  stomach  ;  dull  shocks  in  the  pit  of  the  stomach ; 
violent  dull  stitching  shocks  in  the  pit  of  the  stomach,  slowly 
going  and  coming;  gnawing  and  writhing  sensation  in  the 
stomach  early  in  the  morning,  with  canine  hunger  and  accu- 
mulation of  water  in  the  mouth,  not  relieved  by  eating. 

Abdomen.  Colic  toward  evening  increased  by  raising 
one's  self  in  the  bed,  and  then  ceasing  gradually ;  great  dis- 
tension of  the  abdomen  in  the  evening ;  spasmodic  disten- 
sion of  the  abdomen  in  several  places,  causing  elevations 
and  depressions  on  the  surface ;  sensation  in  the  whole  of 


PLATINA.  399 

the  abdomen,  as  if  she  had  laced  herself  too  tightly ;  sensa- 
tion in  the  whole  abdomen,  as  of  being  pinched  together 
from  the  umbilicus  to  the  back ;  painful  pinching  under  the 
left  short  ribs;  jerking  pinching  in  various  parts  of  the 
abdomen ;  jerking  drawing  in  the  right  side  of  the  abdomen, 
with  some  arrest  of  breathing ;  a  darting  pain  through  the 
abdomen,  succeeded  by  weariness  of  the  knees ;  drawing 
through  the  abdomen,  from  the  chest  toward  both  groins, 
this  drawing  terminates  in  the  genital  organs,  where  it 
causes  a  pain ;  a  writhing  sensation  around  the  umbilicus, 
with  oppressed  breathing,  and  a  tremulous  sensation  through 
the  whole  body ;  very  painful  stitch  deep  in  the  abdomen 
above  the  umbilicus',  when  suddenly  raising  one's  self  after 
cowering ;  dull  stitches  in  the  middle  of  the  umbilicus ;  dull 
shocks  in  the  abdomen,  at  intervals,  below  the  short  ribs ; 
stitches  in  the  abdomen  in  the  morning ;  fine  stinging  in  the 
right  side  of  the  abdomen,  moving  in  the  umbilical  region 
when  lying  upon  the  affected  side,  but  increasing  when  lying 
on  the  left  side;  anxiety  in  the  whole  abdomen,  succeeded 
by  a  pain  in  the  abdomen  as  after  fright,  accompanied  by 
a  desire  as  if  diarrhoea  would  come  on;  slight  burning 
around  the  umbilicus ;  sudden  burning  darting  from  above 
downward  in  the  right  side  of  the  abdomen ;  burning  sensa- 
tion in  a  small  spot  of  the  left  side  of  the  abdomen,  in  parox- 
ysms ;  sudden  jerking,  resembling  a  dull  shock  in  a  small 
spot  in  the  abdominal  integuments;  dull  contusive  pain 
below  the  umbilicus  in  the  integuments ;  dull  shocks,  a  sort 
of  beating  in  the  region  of  a  true  lower 'rib;  motion  in  the 
abdomen  as  of  flatulence;  rumbling  in  the  epigastrium 
before  breakfast ;  rubbing  sensation  in  the  abdomen,  before 
breakfast,  with  a  pinching  anxiety  in  the  intestines ;  emission 
of  short,  interrupted  flatus,  sometimes  difficult;  copious 
emission  of  flatulence. 

Constipation,  lasting  several  days. 

Constant  tenesmus. 

Frequent  ineffectual  desire  for  stool,  or  with  scanty  stool, 


400  PLATINA. 

which  passes  only  part  at  a  time,  with  violent  straining  and 
painful  sensation  of  weakness  and  tension  in  the  abdominal 
muscles. 

Difficult  stool,  with  cutting,  burning,  and  protrusion  of 
the  varices. 

Stool  hard,  as  if  burned,  with  slight  tenesmus  before  and 
after  it. 

Scanty,  tenacious  stool,  cohering  like  clay,  with  long  press- 
ing and  straining  of  the  abdominal  muscles. 

Papescent  stool  in  the  morning,  half  digested  and  some- 
what bloody ;  afterward,  increased  tension  in  the  left  hypo- 
chondrium  and  loins. 

Papescent  stool  in  the  evening,  with  ^scarides. 

Tenesmus,  with  evacuation  of  a  piece  of  tape-worm. 

Violent,  noisy  evacuation  after  dinner,  first  thin,  then 
solid,  expelled  in  fragments  almost  pulverulent,  with  great 
straining ;  after  the  expulsion  he  feels  a  shaking  and  shud- 
dering, especially  in  the  upper  part  of  the  body ;  and  after 
rising  from  stool  he  feels  a  slight  pain  and  weakness  about 
the  umbilicus;  considerable  tenesmus,  even  when  the  stool 
is  not  hard,  and  after  every  stool  a  violent  stitch  in  the  anus, 
with  subsequent  cramp-like  contraction  of  the  nates,  extend- 
ing toward  the  small  of  the  back. 

Shuddering  after  stool  and  urination. 

Much  discharge  of  blood  from  the  anus. 

Tingling  tenesmus  in  the  anus,  as  if  diarrhoea  would  set  in, 
every  evening  before  going  to  sleep,  at  the  same  hour  each  day. 

Burning  in  the  rectum  during  stool,  and,  afterward,  violent 
itching. 

Violent,  dull  stitches  in  front  part  of  the  rectum,  so  that 
she  could  cry  out. 

Urine  pale  yellow  in  the  morning,  clear  as  water  in  the 
afternoon. 

Very  red  urine,  with  white  clouds. 

Urine  becomes  turbid,  and  leaves  a  red  stain  on  the  sides 
of  the  vessel. 


PLATINA.  4OI 

If  we  cast  a  glance  over  all  these  symptoms,  we  find  here 
torpor  of  the  intestinal  canal  distinctly  pronounced.  The 
flatulent  colic,  which  is  clearly  depicted  in  the  symptoms, 
depends,  here,  on  a  paralytic  weakness  of  the  whole  intesti- 
nal tract.  The  peristaltic  action  is  diminished ;  hence  an 
inordinate  development  or  retention  of  intestinal  gas,  and 
manifold  digestive  disorders,  as  consequences.  Eructations, 
nausea,  anorexia,  partial  or  complete,  oppression  at  the 
stomach,  fullness,  distension  of  the  stomach  and  abdomen, 
distension  of  an  isolated  part  of  the  abdomen  and  drawing 
in  of  the  rest,  cutting,  gnawing,  wrenching,  gurgling,  finally, 
discharge  of  flatus,  sometimes  very  troublesome ;  constipa- 
tion, very  dry  or  papescent  stools,  containing  half-digested 
matter, — all  these  phenomena  furnish  clear  evidence  of  the 
torpidity  of  the  muscular  fiber,  or,  rather,  of  the  diminished 
activity  of  the  intestinal  motor  nerves.  Homceopathists  are 
acquainted  with  several  remedies  which  develop  in  a  high 
degree  the  signs  of  flatulence  and  its  attendant  difficulties. 
I  mention  only  for  example  Colocynth,  which  is  sure  to 
occur  to  the  mind  of  every  homceopathist  when  flatulence  is 
mentioned.  But  the  flatulence  of  Colocynth  depends  rather 
on  an  abnormal  composition  of  the  gastric  juices,  and  a 
vicious  bilious  secretion ;  hence  the  bitter  taste,  the  green 
vomiting,  the  abdominal  pain  after  anger,  the  altered  color 
of  the  stools.  The  Platina  symptoms,  on  the  other  hand, 
indicate  by  no  means  an  altered  composition  of  the  fluids 
necessary  to  digestion;  and  nothing  is  left  to  which  to 
attribute  the  flatus  and  other  abnormal  symptoms  of  the 
intestinal  canal,  save  a  diminished  activity  of  the  intestinal 
muscular  fiber. 

IV.      AFFECTIONS  OF  THE  MOTORY  NERVOUS  APPARATUS. 
SPASMODIC  PHENOMENA. 

Cramp-like  feeling  of  contraction  darts  suddenly  through 
the  head  from  the  right  temple  to  the  left;  then,  feeling  of 
27 

l-hv 


4O2  PLATINA. 

dullness,  as  if  too  tightly  bound,  with  trembling,  both  sides 
of  the  head. 

Cramp  in  the  cervical  muscles,  as  if  from  lying  on  too 
hard  a  pillow ;  worse  on  motion. 

Cramp  in  the  hand  on  exerting  it. 

The  finger  is  drawn  crooked,  with  painful  drawing  up  in 
the  arm  on  bending  the  arm. 

At  night,  after  rising,  cramp  and  contraction  of  the  soles 
of  the  feet. 

Great  inclination  to  violent,  almost  spasmodic,  yawning. 

Yawning,  afternoon,  without  sleepiness. 

Frequent  yawning,  afternoon,  so  violent,  her  eyes  overflow. 

Violent  yawning  after  a  meal,  so  that  the  cervical  muscles 
become  painful. 

A  chill  runs  over  the  whole  body  after  yawning. 

Jerking  of  the  muscles  in  the  legs  after  walking  a  little. 

Cramp-like  jerking  here  and  there  in  the  limbs,  like 
throbbing. 

Painful  trembling  of  the  whole  body,  with  throbbing  in 
the  vessels. 

Trembling  sensation,  at  times,  through  the  whole  body. 

First,  a  trembling  sensation  in  the  hands  and  feet,  then 
chilliness  and  violent  trembling  of  the  whole  body,  as  if  in 
the  most  violent  chill,  with  chattering  of  the  teeth,  the  face 
at  the  same  time  being  warm  and  the  hands  cold. 

The  trembling,  which,  standing  midway  between  spasm 
and  paralysis,  is  often  met  with  in  the  pathogenesis  of 
Platina,  and  is  associated  in  it  with  many  other  morbid 
phenomena,  leads  us  very  naturally  to  disturbances  of 
another  nature  in  the  province  of  the  motory  nervous 
system. 

PARALYTIC  PHENOMENA. 

Weakness  in  the  nape  of  the  neck ;  the  head  sinks  for- 
ward. 

Weakness  in  the  nape ;  she  cannot  hold  up  the  head. 


PLATINA.  403 

Relaxed  feeling  in  both  arms,  as  if  they  had  held  up 
something  heavy ;  diminished  by  moving  them  to  and  fro, 
but  returning  immediately  when  they  are  at  rest,  with  draw- 
ing, as  on  a  thread,  from  the  shoulder  to  the  hand. 

Sudden  paralysis,  as  after  an  apoplectic  fit,  in  a  small 
spot,  now  of  the  right,  now  of  the  left  arm. 

Heaviness  of  the  arms. 

Feeling  as  if  paralyzed  in  the  left  arm ;  she  has  to  let  it 
sink  down ;  much  worse  when  resting  the  arm  on  the  chair, 
when  sitting,  even  when  leaning  the  shoulder  against  the 
chair. 

Weariness  and  weakness  of  the  left  arm,  with  drawing 
in  it. 

Paralytic  feeling  in  the  right  fore-arm,  drawing  from  above 
downward. 

Weakness,  with  trembling  disquiet  in  the  thighs,  especially 
toward  the  knees,  as  when  tired  by  walking,  felt  only  when 
sitting. 

Weakness  in  thighs  (and  whole  limbs),  as  if  beaten,  with 
tremulous  uneasiness  in  them,  when  sitting  and  standing. 

Great  weakness  in  the  knee-joints  and  their  neighborhood, 
more  when  standing  than  when  walking,  worst  when  going 
upstairs. 

Weakness  in  the  knees  when  walking,  also  in  the  thighs 
when  sitting,  as  if  fatigued  by  walking. 

Tottering  when  walking,  as  if  the  limbs  had  no  firm 
footing. 

Weakness,  especially  when  sitting ;  the  feet  feel  as  if  over- 
fatigued,  and  are  full  of  trembling  uneasiness. 

The  phenomena  resembling  paralysis  are  much  more 
clearly  defined  than  are  the  spasmodic  affections.  The 
whole  muscular  system  appears  dormant,  and  seems  to  have 
lost  its  tone.  Even  in  sitting  and  leaning  the  body  against 
a  solid  object,  this  weakness  and  laxity  of  fiber  are  significant 
enough  to  warrant  the  conclusion  that  many  forms  of  disease 
resembling  paralysis  must  find  a  remedy  in  Platina.  Thus, 


404  PLATINA. 

on  the  motor  nerves,  our  remedy  acts  as  a  depressing  agent, 
taking  from  them  their  wonted  energy  and  only  here  and 
there,  through  its  inroad  upon  their  activity,  provoking 
spasmodic  phenomena  of  slight  importance. 

Let  us  now  go  farther,  and  see  whether  the  distinctive 
characteristic  of  Platina  displays  itself  in  any  other  nervous 
system  subject  to  the  control  of  the  brain. 


V.      AFFECTIONS   OF  THE  SENSITIVE   NERVOUS  SYSTEM. 

We  have  here  phenomena  of  two  kinds  to  consider, — 
Anesthesia  and  Pain. 

A .  —A  N&STHESIA . 

Tensive,  numb  feeling  in  the  whole  sinciput,  as  after  a 
blow,  extending  as  far  as  the  nasal  bone ;  numb  feeling  in 
the  sinciput,  as  if  constricted,  in  a  warm  room  full  of  persons, 
increased  after  a  short  time  to  a  violent  pressing  together, 
with  a  sensation  as  of  a  dull  digging  up,  with  impatience 
and  ill-humor,  and  heat  on  the  upper  part  of  the  body, 
especially  in  the  head,  as  if  the  sweat  of  anguish  would 
break  out ;  in  the  evening,  when  in  the  cool  air,  he  feels  an 
unusual  heat,  and,  when  beginning  to  walk,  a  painful 
shaking  of  the  brain,  as  if  a  ball  were  knocking  against  the 
skull ;  afterward  the  same  sensation  is  felt  when  lying  in 
bed,  accompanied  with  a  slight  roaring  in  the  ears;  when 
the  pain  abates  he  falls  asleep. 

Feeling  of  coldness,  creeping,  and  numbness  in  the  whole 
right  side  of  the  face. 

Cramp-like  painful  feeling  of  numbness  in  the  left  side 
of  the  zygoma. 

Tensive  feeling  of  numbness  in  the  zygomata  and  mastoid 
processes,  as  if  the  head  were  compressed  by  screws. 

Feeling  of  numbness  in  coccyx,  as  if  after  a  blow  when 
sitting. 


PLATINA.  405 

Tensive  feeling  of  numbness  in  the  nape  of  the  neck,  just 
at  the  occiput,  as  if  bound  together. 

Sensitive  feeling  of  numbness  and  trembling  of  the  right 
thumb,  in  the  morning,  as  if  contused. 

Trembling  feeling  of  numbness  in  the  knees,  and  extend- 
ing to  the  feet,  as  if  too  tightly  bound. 

Feeling  of  numbness,  and  weakness,  and  dull  pressure  on 
the  inner  side  of  the  bend  of  the  left  knee,  when  sitting. 

Cramp-like  jerking  of  the  legs  from  above  downward, 
with  a  feeling  of  stiffness,  which  is  also  felt  in  the  feet  when 
sitting,  especially  in  the  evening. 

Tremulous,  creeping  uneasiness  in  the  legs  when  sitting, 
with  feeling  of  numbness  and  stiffness,  especially  increased 
in  the  evening,  and  also  in  bed. 

Feeling  of  numbness  and  weariness,  in  the  feeling  only, 
when  sitting,  as  if  after  standing  a  long  time. 

B.— PAINS  AND  SENSATIONS. 

The  true  character  of  Platina  is  clearly  depicted  in  the 
feelings  of  dullness  and  numbness.  Now,  even  if  we  assume, 
with  the  majority  of  physiologists,  that  pain  consists  in  an 
exalted  activity  of  the  sensitive  nerve,  then,  notwithstanding, 
Platina  produces,  as  we  shall  see,  no  small  number  of  pain- 
ful sensations,  still,  paradoxical  as  this  may  at  first  view 
appear,  the  general  character  of  Platina,  viz.,  that  of  depres- 
sion, is  clearly  manifested  in  the  form  which  the  Platina 
pains  assume.  No  substance  which  acts  on  the  human  body 
leaves  unaffected  the  sensitive  nerves  so  easily  and  quickly 
excitable.  Hence,  we  find,  that  in  all  provings  of  drugs  on 
the  healthy  body,  a  greater  or  less  number  of  pains  occur. 
But  for  the  very  reason  that  flam  so  frequently  accompanies 
the  pathological  modifications  of  the  organism,  it  is  incapable 
of  serving,  in  its  generality  as  pain,  as  an  index  for  the  dis- 
covery of  the  peculiar  character  of  a  drug.  If  we  received 
it  as  our  guide,  we  should  always,  of  necessity,  infer  an 


406  PLATINA. 

increased  activity.  It  is  necessary,  therefore,  to  examine  the 
determining  conditions  in  which  the  pains  originate,  in  order 
to  form  an  opinion  as  to  whether  the  pains  are  induced  by 
congestion  or  anaemia,  by  inflammation,  or  by  a  condition  of 
paralysis,  etc.,  etc.  In  determining  the  character  of  a  drug, 
then,  the  pains  and  sensations,  inasmuch  as  they  occur 
almost  universally,  are  to  be  subordinated  and  accommodated 
to  the  other  phenomena.  Perhaps  the  kind  of  pain,  whether 
more  of  a  sticking  or  squeezing,  more  of  a  tearing  or  con- 
tracting, more  of  a  pressing  or  pinching  pain,  stands  in  some 
relation  to  the  nature  of  the  drug  which  produces  the  pain, 
and  so  may  contribute  somewhat  to  the  unfolding  of  the 
latter.  We  shall  lay  no  greater  stress,  however,  on  this 
assumption,  which  is  quite  hypothetical,  than  on  this,  that 
the  kind  of  pain  depends  on  the  tissue  in  which  it  originates. 

I  will  enumerate  briefly  the  various  pains  and  sensa- 
tions which  Platina  excites,  naming,  at  the  same  time,  the 
parts  in  which  they  especially  occur  ;  and  I  have  endeavored 
to  indicate,  by  the  order  of  succession,  what  kinds  of  pain 
occur  most  frequently,  and  what  kind  less  often. 

Cramp-pain  (head,  forehead,  temples,  orbital  margins, 
ears,  nose,  zygoma,  lower  maxilla,  teeth,  fauces,  chest,  nape, 
throat,  fore-arm,  hand,  fingers,  hips,  limbs,  thighs,  legs,  calf, 
tarsus,  heel,  toes). 

Oppression  (head,  eyes,  nose,  zygoma,  epigastrium,  ribs, 
genitals,  chest,  back,  shoulders,  fore-arm,  ham,  sole  of  foot, 
toes). 

Oppression,  wave-like,  over  the  right  orbit. 

Pressing  (forehead,  rectum,  GENITALS). 

Pressing  together  (forehead). 

Pressing  inward,  cramp-like  (temples,  vertex). 

Tension  (temples,  orbital  margins,  globe  of  the  eye,  chin, 
nape,  hips,  thighs,  ham,  calf,  dorsum  of  the  foot,  toes). 

Drawing  (head,  ears,  teeth,  gullet,  epigastrium,  abdomen, 
scapula,  hand,  finger,  thigh,  knee,  calf,  heel). 

Drawing  together  (head,  temples,  epigastrium,  abdomen). 


PLATINA.  407 

Tenesmus  (anus). 

Jerking  (nose,  soles  of  the  feet). 

Sticking  (head,  meatus  auditorius,  cheeks,  gullet,  gastric 
region,  abdomen,  rectum,  praecordia,  back,  axilla,  hand, 
cruro-tarsal  joint,  ball  of  the  foot,  toes). 

Crawling,  itching,  prickling,  tickling  (temples,  lower 
maxilla,  corners  of  the  eyes,  face,  nose,  tongue,  epigastrium, 
arms,  genitals,  chest,  thyroid  region,  hand,  ringers,  thumbs, 
limbs,  knees,  ankle-bones,  soles  of  feet,  toes). 

Chafing  (orbital  margins,  tips  of  ears,  nose,  cheeks,  parts 
about  the  mouth,  chin,  genitals,  scrotum,  hand,  feet,  and 
soles). 

Burning  (head,  eyes,  ears,  tongue,  region  of  umbilicus, 
abdomen,  rectum,  chest,  arm,  elbow,  hand,  knee,  toes). 

Pain  as  from  a  blow  or  thrust  (head,  temples,  arch  of 
eyebrow,  abdomen,  coccyx,  shoulder,  arm,  limbs,  thighs, 
knee). 

Numbness  and  feeling  as  of  paralysis  (head,  cheeks,  lips, 
nose,  face,  zygoma,  chin,  coccyx,  nape,  arm,  fore-arm,  hand, 
thumb,  limbs,  thighs,  knees,  hollow  of  the  knee,  feet). 

Feeling  of  coldness  (head,  eyes,  cheeks,  lips,  face,  chin, 
scapula,  hand). 

Throbbing  and  throbbing  pain  (teeth,  region  of  stomach, 
ribs,  fore- arm,  legs,  toes). 

Soreness  (eyes,  lips,  palate,  back,  legs,  ankle-joints,  and 
bones). 

Tearing  (ears,  thigh,  dorsum  of  foot,  toes). 

Shocks  and  blows  (chin,  epigastrium,  chest,  back,  skin,  calf). 

Startings  (ears,  chin,  legs). 

Jerking  and  jerking  pain  (upper  lip,  gastric  region 
(visible),  abdomen,  fore-arm,  limbs). 

Feeling  as  if  burned  (upper  lip,  tongue). 

Feeling  as  if  beaten  (arm,  thigh). 

Feeling  as  if  dislocated  (knee,  ankle). 

Feeling  as  if  contused  (head,  mastoid  process,  elbow, 
thumb,  knee). 


408  PLATINA. 

Pain  of  excoriation  (back,  scapula). 

Pinching  (umbilical  region,  epigastrium,  abdomen). 

Dull  pains  (head,  teeth,  arm,  thigh). 

Cutting  (abdomen,  dorsum  of  foot). 

Digging  (forehead,  ears,  teeth). 

Boring  (forehead). 

Scratching  (gullet). 

The  pain  most  frequently  encountered  in  Platina  provings 
is  cramp-pain.  We  meet  with  this  in  almost  every  part  of 
the  body.  The  following  symptoms,  for  example,  present 
modifications  of  it. 

"Tensive  pain  in  both  upper  orbital  margins,  extending 
to  the  globe  of  the  eye  itself;  they  are,  as  it  were,  com- 
pressed. 

"  In  the  left  ala  nasi  cramp-like  jerkings  at  regular  inter- 
vals ;  cramp-like  jerkings  at  regular  intervals  in  a  small  spot 
below  the  external  knuckle  of  the  right  hand." 

The  sensation  of  pressing  inward,  too,  is  a  very  frequent 
symptom  of  Platina.  In  addition  to  the  instances  in  which 
this  is  distinctly  expressed,  the  following,  among  other 
symptoms,  seem  to  belong  to  this  sensation: 

"  In  the  left  side  of  the  forehead,  a  sudden,  fugitive 
pressing  inward,  as  by  a  dull  body. 

"  Fugitive  pain  in  the  middle  of  the  vertex,  a  pressing 
inward. 

"Dull  pain  in  the  right  parietal  bone,  as  if  a  plug  were 
forced  there. 

"  In  the  middle  of  the  back,  on  the  right,  near  the  spine, 
violent  pain,  as  if  a  sharp  plug  were  fixed ;  on  pressing  upon 
it,  pain  like  a  sore  wound,  continuing  a  long  time. 

"  Behind,  on  the  left  mastoid  process,  pressing  pain,  as 
if  by  a  dull  instrument ;  on  pressure,  pain  as  from  a  con- 
tusion. 

"  On  a  small  spot,  above,  on  the  thorax,  painful  sensa- 
tion, as  if  one  pressed  powerfully  on  it,  with  a  dull  body." 

Just  as  frequent   as  the  cramp-pain  is  in  the  muscular 


PLATINA.  409 

tissue,  is  the  feeling  of  itching  in  the  skin.  We  find  it  under 
various  forms,  e.  g.  : 

"  On  the  upper  margin  of  the  orbit  a  kind  of  sore,  eating 
sensation,  as  if  caused  by  excoriation. 

"  On  the  scrotum  a  frequent  sore,  corrosive  sensation,  as 
if  from  excoriation  by  woolen  cloth,  so  that  he  must  change 
his  position  frequently,  especially  when  sitting,  also  when 
lying  in  bed ;  many  days,  above  and  around  the  ankle-joint 
and  bones,  a  smarting  and  sore  gnawing  sensation ;  if,  when 
walking,  the  clothes  strike  against  the  uncovered  foot,  the 
part  pains  as  if  raw  and  excoriated  ;  sticking,  gnawing  in  a 
small  spot  on  the  left  sole,  compelling  him  to  scratch  the 
part. 

"  Tingling  in  the  nose,  as  from  snuff,  or  as  before  epistaxis, 
compelling  him  to  rub  the  nose,  causing  the  eyes  to  water, 
and  inducing  a  vain  desire  to  sneeze. 

"  On  the  knuckles  and  finger,  a  burning  prickling,  as  if  he 
had  touched  stinging  nettles,  compelling  him  to  scratch 
vigorously. 

"  On  the  left  elbow,  a  kind  of  sore  burning,  as  if  scraped, 
or  abraded  by  woolen  cloth. 

"  On  the  right  temple,  formication,  passing  down  the  right 
side  of  the  cheek  and  lower  jaw,  with  a  sensation  of  cold. 

"  Formication  and  sensation  as  of  a  cold  breeze  in  the  left 
hand. 

"  At  a  little  spot  on  the  left  parietal  bone,  at  intervals,  a 
kind  of  dull,  corrosive  sticking." 

A  peculiarity  of  the  itching,  burning,  prickling,  etc.,  is, 
that  the  scratching  and  rubbing,  to  which  they  usually 
compel  the  patient,  afford  only  a  very  brief  amelioration. 

Nearly  related  to  the  cramp-pain  of  Platina,  is  the  sensa- 
tion of  contraction  and  constriction,  to  be  found  in  the 
following  symptoms : 

"  The  head  seems  to  him,  as  it  were,  compressed  in  a 
frame  ;  a  dull,  painful  sensation. 

"  Cramp-pain  in  the  forehead,  as  if  between  screws. 


410  PLATINA. 

"  In  a  somewhat  warm  room  (with  many  persons),  first  a 
feeling  of  dullness  in  the  sinciput,  as  if  contracted ;  this 
increases  more  and  more  to  a  violent  headache,  first,  in  the 
right  temple,  later,  in  the  whole  head,  but  always  worst  in 
the  forehead ;  a  dull,  sometimes  dizzy  compression,  with 
very  cross  and  impatient  humor ;  at  the  same  time  heat  in 
the  upper  part  of  the  body,  especially  the  head;  an  anxious 
sweat  seems  about  to  break  out ;  every  minute,  a  flash  of 
heat  runs  over  him ;  nothing  relieves  this  condition,  which, 
if  it  moderate  for  an  instant,  returns  quickly  with  violence. 
In  the  evening,  when  standing  in  the  cool  air,  he  is  uncom- 
monly warm  (no  thirst).  When  beginning  to  walk,  after  a 
short  rest,  the  brain  is  painful,  as  if  shaken,  or,  as  if  a  sensi- 
tive ball,  lying  loose  in  the  head,  struck  against  the  cranial 
walls.  In  the  evening,  in  bed,  in  addition  to  the  dull  feeling 
in  the  forehead,  a  roaring  in  the  ears ;  then,  when  the  pains 
abate,  he  sleeps. 

"  Tensive,  dull  feeling  in  the  nape  of  the  neck,  just  on  the 
occiput,  as  if  tightly  bound  together. 

"  A  kind  of  spasmodic  contractive  sensation  darts  quickly 
and  suddenly  from  the  right  temple,  through  the  head,  to 
the  left  temple  ;  later,  the  head  feels  numb  and  trembling 
on  both  sides,  as  if  a  cloth  were  wound  tightly  about  it. 

"  In  the  left  great  toe,  a  painful  sensation,  as  if  tightly 
bandaged." 

It  is  characteristic  of  the  morbid  phenomena  induced  by 
Platina,  that  they  often  appear  at  regular  rhythmical  inter- 
vals, and,  beginning  feebly,  become  more  violent,  and  then 
again  diminish  in  intensity. 

"  In  the  epigastrium,  to  the  left,  a  few  violent,  dull  stitches 
like  shocks,  at  long  intervals. 

"  In  the  left  ulna,  two  inches  from  the  wrist,  at  intervals, 
pain  in  every  position,  like  a  kind  of  jerking,  especially  in 
the  tendons. 

"  Below  the  knee,  from  the  right  tibia  down,  painful  shocks 
at  irregular  intervals,  as  from  a  dull  instrument. 


PLATINA.  411 

"  A  pressing  cramp-pain  in  the  left  temple,  beginning 
moderately,  and  rising  and  falling  in  severity. 

"  In  left  side  of  thorax,  a  cramp- like  pain,  moderate  at 
first,  gradually  increasing,  and  then  decreasing. 

"  On  top  of  the  right  shoulder,  a  pain  as  from  a  blow, 
moderate  at  first,  then  gradually  increasing,  and  then 
decreasing." 

A  farther  peculiarity  of  the  Platina  symptoms  is  that  they 
become  aggravated  by  sitting  and  standing,  and  are  alleviated 
by  walking, — a  feature  agreeing  exactly  with  the  general 
character  of  the  drug. 

The  following  symptoms  come  under  this  head : 

"  When  sitting  and  standing,  a  painful  feeling  of  weakness 
in  the  whole  right  limb,  especially  in  the  superficial  muscles 
of  both  thighs,  as  if  beaten,  with  a  tremulous  uneasiness. 

"  When  sitting,  a  dull  pain,  as  from  a  fall,  in  the  head  of 
the  left  thigh. 

"  Great  weakness  in  the  knee-joints  and  surrounding  parts, 
even  when  sitting,  but  especially  when  standing,  making  him 
sway  back  and  forth  involuntarily. 

"  When  walking,  he  feels  but  little  weakness ;  but,  so  soon 
as  he  sits,  the  feet  are  as  if  tired,  trembling,  and  full  of 
uneasiness." 

Another  characteristic  of  the  Platina  symptoms  is  the 
evening  exacerbation. 

"  Spasmodic  jerkings  down  the  left  thigh,  and  feeling  of 
numbness  in  the  legs  and  feet  when  sitting,  especially 'in  the 
evening. 

/'Feeling  of  fatigue  in  the  soles,  with  a  sensation  as  if 
they  were  swollen  around  the  ankles.  When  sitting,  the 
fatigue  ascends  gradually  into  the  calves,  with  a  sensation  as 
if  they  were  stretched,  in  the  evening. 

"In  the  afternoon  and  evening  she  feels  in  her  worst 
humor." 

A  farther  peculiarity  of  Platina,  which  should  not  be  over- 
looked, is  that  strikingly  prominent  sensation  of  cold  and 


412  PL  A  TIN  A. 

chilliness  which,  as  already  stated,  attends  many  phenomena, 
and  often  appears  independently.  We  shall  be  less  likely  to 
regard  this  chilliness  and  feeling  of  coldness  as  a  febrile 
symptom,  or  a  disturbance  in  the  sphere  of  the  Sympathetic, 
inasmuch  as  we  perceive  no  reaction  of  any  kind, — heat, 
sweat,  or  change  of  pulse. 

These  phenomena  of  chill  and  coldness  are,  here,  rather  a 
reflex  action  on  the  sensitive  nervous  system,  dependent  on 
the  torpor  peculiar  to  this  drug.  I  do  not  therefore  hesitate 
to  cite  here  the  following  symptoms : 

"  Chill,  with  chattering  of  the  teeth,  in  the  evening,  when 
undressing. 

"  Constant  feeling  as  if  he  should  freeze,  with  frequent 
shuddering  down  the  limbs,  especially  in  the  open  air,  even 
when  it  is  warm. 

"  Cold,  with  shivering  over  the  whole  body,  down  to  the 
feet. 

"  Cold  chill  running  over  the  back. 

"  Shivering  from  cold,  evening. 

"  Constant  shuddering  through  the  whole  body,  especially 
the  limbs. 

"Frequent  shuddering  from  above,  down  the  arm  and  the 
whole  body,  with  horripilation. 

"A  shiver  runs  over  her  when  she  steps  from  her  chamber 
into  the  open  air. 

"  Sudden  shiver  on  head,  chest,  and  arms,  after  entering  a 
warm*  room. 

"  Shivering  in  the  forenoon,  with  drowsiness. 

"  She  becomes  suddenly  quite  warm,  and  fancies  she  looks 
very  red,  although  her  complexion  is  as  usual." 

I  have  dwelt  at  somewhat  greater  length  on  the  functional 
affections  of  the  sensitive  nerves,  because  it  is  in  just  these 
effects  that  many  peculiarities  and  characteristic  features  of 
Platina  are  most  strikingly  prominent;  for  phenomena  present 
themselves  here,  as  we  have  seen,  which  serve  as  important 
points  in  the  general  indications  of  the  remedy. 


PLATINA.  413 

It  only  remains,  for  the  sake  of  completeness,  to  cite  a  few 
symptoms,  which,  even  if  of  no  great  importance,  yet  serve 
to  fill  out  the  picture  of  the  Platina  disease.  These  symp- 
toms relate  to  the  organs  of  special  sense : 


VI.     AFFECTIONS   OF    THE    SENSORIAL    NERVOUS    SYSTEM. 

"  Painful  drawing  around  the  left  eye,  seeing  as  if  through 
gauze,  and  sensation  as  of  the  eyes  being  agglutinated.  The 
eyes  are  painful  when  using  them  in  the  evening,  at  candle- 
light, and  when  exerting  them  ;  they  first  itch,  obliging  her 
to  rub  them ;  then  they  suppurate,  are  very  painful,  see  a 
tremulous  and  twinkling  light,  obliging '  her  to  close  them, 
and  making  it  impossible  for  her  to  see  any  object. 

"  Tingling  of  the  ears ;  tingling  of  the  ears,  afterward 
tearing  in  the  same ;  whizzing  in  the  ears,  with  stitches  in 
the  head  ;  noise  in  the  ears,  as  of  the  wind  blowing  into  them, 
increased  by  the  least  noise  to  such  an  extent  that  she  has 
great  difficulty  in  hearing  others ;  roaring  in  the  right  ear ; 
noise  in  the  right  ear,  as  of  the  wing  of  a  large  bird ;  dull 
roaring  and  rolling  in  the  ear  every  morning,  and  afterward 
every  evening  after  lying  down,  at  the  same  hour  for  several 
weeks ;  dull  roaring  in  the  right  ear,  with  obtusion  of  the 
head  from  a  sort  of  cramp-like  pressure;  jerks  in  the  right 
ear  like  distant  thunder." 

Finally,  a  few  symptoms  belonging  to  the  male  genital 
system  remain  to  be  cited : 

"Erections  toward  morning. 

"  Constant  erections  during  sleep,  with  amorous  dreams. 

"Constant  erections  at  night  without  seminal  emission,  and 
without  many  dreams. 

"Embrace  with  little  pleasure,  and  very  brief." 

These  symptoms  agree  with  the  general  character  of 
Platina.  The  erections  are,  if  I  may  use  the  expression, 
passive,  and  are  attended  by  no  desire;  hence,  erections 


414  PLATINA. 

without  emission  and  embrace  of  short  duration  with  very 
little  pleasure. 

Having  thus  taken  a  survey  of  the  general  and  special 
sphere  of  action  of  Platina,  I  shall  now  consider  several 
remedies  that  are  related  to  it,  and  briefly  refer  to  the 
diagnostic  difference  between  them  and  Platina.  First  of  all 
I  name  Asafoetida.  This  remedy,  as  well  as  Platina,  exhibits 
many  of  the  phenomena  of  hysteria,  but  of  an  altogether 
different  form  of  that  disease.  Menstruation,  too,  is  rendered 
more  frequent  by  Asafcetida ;  still,  however,  it  remains  scanty. 
The  hysteric  perversion  of  the  disposition  and  morale  are 
clearly  induced,  it  is  true,  by  Asafcetida,  and  even  the  globus 
hystericus  is  present ;  but  then  Asafcetida  fails  to  induce  the 
disposition  to  weep,  the  fear  of  death,  the  absent-mindedness, 
the  self-exaltation  above  others,  which  are  so  peculiar  to  Platina. 

The  affections  of  the  vegetative  nervous  system  induced 
by  Asafcetida  are  eminently  of  a  spasmodic  nature,  as  well 
as  those  induced  by  Platina;  but  they  seem  to  depend 
partly  upon  a  peculiar  gastric  condition  and  partly  on 
obstructions  in  the  portal  system.  Asafoetida  affects  the 
periosteum,  for  which  Platina  has  no  affinity  at  all.  On  the 
other  hand,  Asafcetida  has  the  trembling,  the  cramp-like 
sensations,  ceasing  and  re-appearing  at  regular  intervals, 
aggravated  by  sitting,  and  ameliorated  by  walking,  in  com- 
mon with  Platina,  although  with  various  modifications  and 
under  different  conditions.  The  paralytic  condition  is  not  so 
clearly  developed  in  the  action  of  Asafoetida.  But  the 
phenomena  which  most  strikingly  distinguish  Asafcetida 
from  Platina  are  the  symptoms  of  congestion  and  fever, 
which,  as  we  have  seen,  are  altogether  wanting  to  the  latter. 
Hence  it  follows,  that  torpor  and  inactivity,  and  prostration 
of  the  functions,  do  not  make  up  the  character  of  Asafoetida; 
but,  as  a  rule,  most  of  its  effects  upon  the  brain  and  spinal 
cord  appear  to  be  reflex  effects  from  affections  of  the  vegeta- 
tive nervous  system,  whereas  the  action  of  Platina  upon 
these  central  organs  is  independent  and  primary. 


PLATINA.  415 

Crocus,  although  far  more  widely  different  than  Asafcetida 
from  Platina,  may  yet  be  reckoned  among  the  related 
remedies,  because,  perhaps,  of  its  affinity  for  the  female 
organism,  and  of  its  action  on  the  morale  and  the  disposition. 
The  too  early  and  too  copious  menstruation  and  the 
metrorrhagia  which  Crocus  induces  depend,  however,  on  an 
overloading  of  the  uterine  vessels  with  blood ;  hence,  the 
blood  is  black  and  clotted;  and,  hence,  the  haemorrhages 
which  occur  also  in  other  organs  are  easily  provoked  by 
motion  or  exertion.  The  moral  effects  are  directly  opposed 
to  those  of  Platina.  In  the  case  of  the  latter  we  have  weep- 
ing and  fear  of  death ;  in  that  of  the  former,  laughing  and 
unrestrained  merriment;  but  the  frequent  alternation  of 
cheerfulness  and  sadness  is  a  feature  common  to  both 
remedies.  When  I  add,  in  conclusion,  that  the  majority  of 
the  morbid  phenomena  of  Crocus  are  induced  by  congestions, 
venosity,  and  other  abnormal  states  of  the  vascular  system, 
we  at  once  perceive  the  distinctions  between  the  remedies. 

Pulsatilla  is  in  several  aspects  similar  and  related  to 
Platina.  But,  from  the  very  fact  that  it  is  a  polychrest, — 
that  is,  that  it  acts  in  very  many  ways,  and  exerts  its  healing 
power  in  a  great  number  of  acute  as  well  as  chronic  diseases, 
— the  difference  of  its  character  from  that  of  Platina  may, 
notwithstanding  their  similarity,  be  clearly  seen.  It  would 
lead  me  too  far  to  unfold  this  difference  in  all  its  aspects ; 
this  may  be  done  with  greater  propriety  when  treating  of 
Pulsatilla.  Only  this  much  I  may  say:  that  the  similarity 
of  Pulsatilla  to  Platina  is  shown  most  clearly  in  their 
respective  moral  effects,  and  in  their  action  on  the  female 
sexual  system.  But  even  in  these  symptoms  there  are 
important  differences,  the  psychical  effects  of  Pulsatilla  con- 
sisting chiefly  in  fretfulness,  complaint,  and  lamentation,  and 
the  disposition  to  weep  which  belongs  to  this  remedy,  arising 
rather  out  of  these  conditions  ;  whereas,  the  weeping  induced 
by  Platina  is  a  result  of  apprehensiveness  and  of  weakness 
of  disposition. 


41 6  PLATINA. 

With  regard  to  menstruation,  Pulsatilla  induces  a  number 
of  abnormal  symptoms,  retards  the  menses,  and  causes  a 
discharge  of  black  clotted  blood.  Hence,  Pulsatilla  is  not 
improperly  regarded  as  antidote  to  Platina. 

Last  of  all,  it  remains  to  mention  Plumbum  aceticum, 
which  shows  much  resemblance  to  Platina  in  its  spasmodic 
and  paralytic  symptoms ;  but  whereas  in  the  case  of  Platina 
these  are  primary,  in  that  of  Plumbum  they  are  secondary. 
On  this  account,  too,  Platina  is  the  remedy  for  certain  cases 
of  lead-colic.  These  two  metals  stand  almost  in  the  same 
relation  that  Arsenic  and  Carbo  vegetabilis  hold.  The 
tendency  to  decompose  everything  of  an  organic  nature  is 
common  to  these  two  remedies ;  but  Arsenic  induces  this 
decomposition  after  a  previous  over-excitement  and  too 
strong  impression  upon  the  organism,  while  the  peculiarity 
of  inducing  decomposition  is  a  part  of  the  primary  action  of 
Carbo. 

The  dose  in  which  Platina  may  be  given  is  various.  I  have 
generally  given  the  second  or  third  trituration,  with  the  best 
results ;  but  I  doubt  not  that  it  is  active  in  higher  potencies, 
this  being  attested  by  the  experience  of  competent  physi- 
cians. 


REMARKS  ON  RUMEX  CRISPUS. 


My  clinical  experience  of  the  last  two  years  has  given  me 
a  feeling  of  great  gratitude  to  Dr.  Joslin,  for  his  introduction 
of  Rumex  Crispus  to  the  profession  by  his  excellent  proving. 
The  value  of  the  published  proving  is  much  enhanced  by 
the  publication  of  the  daily  records  of  each  prover,  which 
enable  the  student  to  appreciate  the  consecutive  action  of 
the  drug  much  more  perfectly  than  the  Hahnemannian 
scheme  allows,  while  the  latter,  again,  is  indispensable  to  the 
prescriber. 

I  have  used  Rumex  chiefly  in  acute  catarrhal  affections  of 
the  larynx,  trachea  and  bronchi.  In  these  cases  it  seems  to 
me  to  present  a  close  analogy  in  its  action,  to  Belladonna, 
Lachesis,  Phosphorus  and  Causticum.  Without  assuming 
to  present  an  exhaustive  analysis  of  the  action  of  Rumex 
on  the  respiratory  organs,  I  proceed  to  state  the  indica- 
tions for  its  use  to  which  my  studies  of  it  thus  far  have 
led  me. 

Rumex  diminishes  the  secretions,  and  at  the  same  time 
exalts  in  a  very  marked  manner  the  sensibility  of  the  mucous 
membrane  of  the  larynx  and  trachea,  exceeding  in  the  extent 
of  this  exaltation  any  remedy  known  to  us.  The  cough 
therefore  is  frequent  and  continuous  to  an  extent  quite  out 
of  proportion  to  the  degree  of  organic  affection  of  the 
mucous  membrane.  It  is  dry,  occurs  in  long  paroxysms,  or, 
under  certain  circumstances,  is  almost  uninterrupted.  It  is 
induced  or  greatly  aggravated  by  any  irregularity  of  respira- 
tion such  as  an  inspiration  a  little  deeper  or  more  rapid 
than  usual,  by  the  inspiration  of  air  a  little  colder  than 
that  previously  inhaled,  by  irregularity  of  respiration  and 
28 


418  REMARKS 'ON   RUMEX   CRISPUS. 

irregular  motion  of  the  larynx  and  trachea  such  as  are 
involved  in  the  act  of  speech  and  by  external  pressure  upon 
the  trachea,  in  the  region  of  the  supra-sternal  fossa.  These 
phenomena  show  a  very  great  morbid  irritability  of  the 
mucous  membrane  of  the  larynx  and  trachea. 

The  subjective  symptoms  are  rawness  and  soreness  in  the 
trachea,  extending  a  short  distance  below  the  supra-sternal 
fossa  and  laterally  into  the  bronchi,  chiefly  to  the  left ;  and 
tickling  in  the  supra-sternal  fossa  and  behind  the  sternum, 
provoking  the  cough  ;  this  tickling  is  very  annoying  and 
very  persistent,  and  is  often  but  momentarily,  and  sometimes 
only  partially,  relieved  by  coughing.  The  cough  occurs 
chiefly,  or  is  much  worse  in  the  evening,  after  retiring,  and 
at  that  time  the  membrane  of  the  trachea  is  particularly 
sensitive  to  cold  air  and  to  any  irregularity  in  the  flow  of  air 
over  its  surface,  so  that  the  patient  often  covers  the  head 
with  the  bedclothes  to  avoid  the  cold  air  of  the  apartment, 
and  refuses  to  speak  or  even  to  listen  to  conversation,  lest 
his  attention  should  be  withdrawn  from  the  supervision  of 
his  respiratory  acts,  which  he  performs  with  the  most  careful 
uniformity  and  deliberation, — and  all  in  the  hope  of  pre- 
venting the  distressing  tickling  and  the  harassing  cough  which 
would  ensue  from  a  neglect  of  these  precautions.  I  have 
frequently  witnessed  this  state  of  things  during  the  last  three 
years,  and  have  invariably  given  prompt  relief  with  Rumex. 

In  the  group  of  remedies  in  which  I  have  placed  Rumex 
(along  with  Belladonna,  Lachesis,  Phosphorus,  Causticum), 
it  stands  pre-eminent  in  respect  to  the  extreme  sensibility 
of  the  tracheal  mucous  membrane.  All  of  these  remedies 
produce  symptoms  identical  in  kind.  The  characteristic  of 
each  is  to  be  found  in  the  relative  degree  in  which  each 
symptom  is  pronounced  in  the  different  remedies,  quite  as 
much  as  in  the  possession  by  any  one  of  them  of  symptoms 
not  produced  by  the  others. 

Thus  Belladonna,  Lachesis  and  Rumex,  produce  each,  a 
dry  cough,  induced  by  tickling  in  the  larynx  or  trachea  and 


REMARKS   ON   RUMEX   CRISPUS.  419 

provoked  by  deep  inspiration,  by  speaking,  and  by  external 
pressure  on  the  larynx  or  trachea.  Each  produces  soreness 
or  rawness  of  the  larynx  or  trachea.  The  cough  of  each  is 
spasmodic  and  long-continued,  and  is  worse  at  night  after 
retiring.  But,  apart  from  the  fact  that  Belladonna  and 
Lachesis  act  more  upon  the  larynx,  and  Rumex  more  upon 
the  lower  part  of  the  trachea,  we  observe  that,  in  the  case 
of  Lachesis,  the  slightest  external  pressure  on  the  larynx  or 
trachea  produces  violent  and  long-continued  spasmodic 
cough ;  the  patient  cannot  endure  the  least  constriction  in  that 
region,  not  even  the  ordinary  contact  of  his  clothing.  There 
is,  moreover,  a  sense  of  fullness  in  the  trachea  and  a  very 
painful  aching  in  the  whole  extent  of  the  os  hyoides.  In 
the  case  of  Belladonna  not  only  is  cough  produced  to  a 
moderate  extent  by  pressing  upon  the  larynx,  but  soreness 
and  pain  are  experienced  with  a  sense  of  internal  fullness 
and  soreness  which  at  once  suggest  the  presence  of  acute 
laryngitis  submucosa.  In  Rumex,  on  the  other  hand, 
there  is  no  sensibility,  strictly  speaking,  of  the  trachea,  but 
simply  such  an  irritability  of  the  mucous  membrane  that 
cough  is  produced  by  the  change  of  position  induced  in  that 
membrane  by  external  pressure  on  the  trachea.  As  regards 
the  extent  and  intensity  of  this  symptom,  Rumex  holds  a 
lower  rank  than  the  other  remedies  named. 

But  the  irritability  of  mucous  membrane  by  virtue  of 
which  cough  is  induced  by  hurried  or  deep  inspiration  or  by 
speaking,  while  it  is  common  to  Belladonna,  Lachesis, 
Rumex  and  Phosphorus,  is  produced  in  the  most  exalted 
degree,  as  we  have  already  seen,  by  Rumex,  which,  as 
regards  this  symptom,  takes  first  rank.  A  sensation  of 
rawness  or  roughness  in  the  larynx,  trachea  and  bronchi  is 
produced  by  each  of  the  four  remedies  above  named,  but 
the  locality  and  the  degree  in  which  it  is  produced  vary  in 
such  a  manner  as  to  serve  in  some  measure  as  a  character- 
istic of  each.  It  is  most  marked  in  Phosphorus  and  Bella- 
donna, less  prominent  in  Rumex,  and  least  of  all  in  Lachesis. 


420  REMARKS   ON    RUMEX   CRISPUS. 

In  Belladonna  and  Lachesis  it  is  most  marked  in  the  larynx  -y 
indeed  it  is  almost  confined  to  that  region.  Rumex  pro- 
duces it  in  the  trachea  and  upper  part  of  the  bronchi,  while 
Phosphorus  induces  it  in  the  whole  mucous  tract  from  the 
larynx  to  the  smaller  bronchi;  and,  moreover,  in  the  Phos- 
phorus proving  this  "rawness"  of  the  air-passages  is  accom- 
panied by  a  no  less  characteristic  sense  of  weight  and 
constriction  across  the  upper  part  of  the  thorax,  which 
indicates  an  affection  of  the  finer  air-tubes  and  of  the  air- 
vesicles  of  such  a  character  as  seriously  to  impede  the  func- 
tion of  respiration.  In  considering  this  last  symptom  we 
must  mention  Causticum  also,  which  produces  "  rawness " 
extending  the  whole  length  of  the  sternum. 

All  five  remedies,  again,  produce  hoarseness  ;  Phosphorus, 
Causticum  and  Belladonna  most  eminently,  Rumex  less 
decidedly,  and  Lachesis  in  a  still  less  degree.  As  regards 
complications,  Belladonna  and  Lachesis  apply  especially  to 
those  which  involve  the  fauces  and  pharynx,  and  are  acute, 
the  one  of  a  sthenic,  the  other  of  an  asthenic  character; 
Phosphorus  to  those  of  the  pulmonary  tissues  of  a  definite 
inflammatory  character,  and  Rumex  to  certain  affections  of 
the  lungs  and  their  envelopes  of  which  the  nature  is  not 
clearly  defined  in  the  proving.  They  are  indicated  by  pains, 
generally  sub-acute,  in  the  upper  part  of  the  lung  near  the 
clavicle  and  axilla,  and  more  frequent  in  the  left  than  in  the 
right  lung. 

In  addition  to  these  observations  on  the  respiratory 
organs,  I  have  noticed,  in  one  case,  the  cessation  of  a  brown 
watery  diarrhoea  after  the  administration  of  Rumex.  A  boy 
of  five  years  had  brown  watery  diarrhoea,  chiefly  in  the 
morning,  having  five  stools  from  five  to  nine  A.M.,  attended 
with  moderate  griping  pain  in  the  lower  part  of  the  abdo- 
men. This  continued  several  days,  notwithstanding  two 
prescriptions  which  I  made  for  it.  Observing  that  the  boy 
had  a  cough  which  presented  the  characteristic  features  of 
the  Rumex  cough,  I  gave  that  remedy,  and  both  diarrhoea 


REMARKS   ON   RUMEX  CRISPUS.  421 

and  cough  were  speedily  cured.  The  symptom  "  brown 
watery  diarrhoea"  occurs  once  in  the  provings.  In  relating 
this  case  I  cannot  forbear  remarking  that  had  I  been  more 
careful  to  collect  and  consider  the  totality  of  the  symptoms, 
embracing  cough  as  well  as  diarrhoea,  I  should  have  given 
Rumex  at  first,  instead  of  making  two  blundering  prescrip- 
tions on  the  basis  of  a  partial  view  of  the  symptoms  which 
embraced  the  diarrhoea  alone. 

The  following  case  from  my  clinical  record  will  illustrate 
the  character  of  the  Rumex  cough : 

M.,  aged  twenty- two,  of  feeble  constitution,  strumous, 
subject  for  several  years  to  sub-acute  rheumatism ;  has  had 
a  severe  cold  for  several  days,  and  is  now  confined  to  the 
bed.  The  pulse  is  quick,  not  hard,  no,  skin  moderately  hot 
and  dry,  face  somewhat  flushed.  Respiration  embarrassed 
not  so  much  by  any  constriction  of  the  chest  as  by  the 
violent  and  long- continued  cough  which  follows  any  attempt 
to  make  a  full  inspiration.  A  physical  examination  of  the 
chest  reveals  no  abnormal  condition.  The  patient  complains 
of  roughness  and  soreness  in  the  lower  part  of  the  trachea 
and  behind  the  upper  third  of  the  sternum,  much  more  per- 
ceptible when  she  coughs.  The  cough  is  dry,  slightly 
hoarse,  very  violent  and  fatiguing  to  the  patient.  It  is  pro- 
voked by  a  tickling  in  the  supra-sternal  fossa;  is  induced 
by  pressure  upon  the  trachea  in  that  region,  and  especially 
by  talking  and  by  deep  inspiration  or  by  the  inspiration  of 
cool  air.  This  irritability  of  the  trachea  increases  very 
markedly  after  7  P.  M.,  so  that  the  patient  suffers  exceedingly 
from  the  constant  tickling  and  violent  cough.  She  can  pre- 
vent them  only  by  respiring  with  very  great  caution  and 
deliberation,  by  avoiding  all  distractions  of  speech  and  con- 
versation, and  finally  she  draws  the  bedclothes  over  the 
head  in  order  to  avoid  inhaling  the  cool  air  of  the  chamber. 

This  patient  states  that  she  has  frequently  had  such  coughs 
as  this,  and  they  have  proved  very  obstinate  although  under 
skillful  homoeopathic  treatment.  I  gave  Rumex 12  in  solution, 


422  REMARKS   ON   RUMEX   CRISPUS. 

a  tea-spoonful  every  two  hours.  After  the  second  dose  there 
was  complete  relief.  The  next  evening,  a  very  slight  dispo- 
sition to  cough.  No  further  symptoms. 

I  supplied  the  patient  with  Rumex30,  and  advised  her  to 
use  it  at  once  on  the  occurrence  of  such  a  cough,  and  I  am 
informed  that  she  has  always  succeeded  in  subduing  the 
cough  within  twelve  hours. 


REMARKS  ON  GUAO.1 

The  Guao  is  undoubtedly  the  "  Comocladia  dentata," 
belonging  to  the  same  family  as  the  Rhus  toxicodendron 
and  venenata,  and  the  Anacardium  occidentale  or  Cashew- 
tree.  Lindley  describes  it  as  follows  : 2 

"  Anacardiacea.  Comocladia  dentata  (Guao).  St.  Domingo 
and  Cuba.  A  tree.  Stem  erect,  not  much  branched.  Leaves 
pinnated,  shining  and  green  above  ;  with  a  round  rachis  six 
inches  long ;  leaflets  six  to  ten  on  each  side,  with  an  odd 
one,  oblong,  acuminate,  spring-toothed,  veiny  and  somewhat 
downy  at  the  back.  Juice  milky,  glutinous,  becoming  black 
by  exposure  to  the  air,  staining  the  linen  or  the  skin  of  the 
same  color,  only  coming  off  with  the  skin  itself,  and  not 
removable  from  linen  by  washing  even  if  repeated  for  many 
years  successively.  It  is  supposed  by  the  natives  of  Cuba, 
that  it  is  death  to  sleep  beneath  its  shade,  especially  for 
persons  of  a  sanguine  or  fat  habit  of  body.  This  is  firmly 
believed,  and  there  can  be  no  doubt  that  it  is  the  most 
dangerous  plant  upon  the  island." 

An  interesting  article  upon  the  "  Comocladia  dentata 
(Guao),"  by  J.  G.  Houard,  M.  D.,  Philadelphia,  comprising 
contributions  toward  a  proving  of  this  plant,  and  some 
symptoms  removed  by  its  administration,  was  published  in 
the  Philadelphia  Journal  of  Homoeopathy? 

It  seems  not  irrelevant  to  call  attention  to  the  fact  that 
the  Guao  (Comocladia  dentata)  may  possibly,  from  the 
similarity  of  the  names,  be  confounded  with  the  Guaco 
(Mikania  guaco),  a  totally  different  plant. 

1  Notes  appended   to   a   Paper  on  *  Flora  Medico,  page  289,  $  598. 

Guao,  written  by  Dr.  Jose"  J.  Navarro,  'Vol.  iv.  (No.  2),  page  73  el  seq.% 

of  Cuba.     American  Homoeopathic  Re-  May,  1854. 
view,  vol.  iii.,  March. 


424  REMARKS   ON    GUAO. 

The  Guaco  (Mikania  guaco)  is  a  climbing  plant  used  in 
Central  and  South  America  as  an  antidote  to  the  poison  of 
serpents.  It  is  incidentally  alluded  to  by  Humboldt:1 
"The  liana,  called  vejuco  de  guaco  (Mikania),  which  M. 
Mutro  has  rendered  so  celebrated,  and  which  is  the  most 
certain  remedy  for  the  bite  of  venomous  serpents." 

"  Forster,  Schomburgh,  Poppig  and  Tschudi,  agree  that 
in  South  America  the  Mikania  guaco  is  the  best  remedy  for 
the  bite  of  venomous  serpents,  and  that  it  has  in  innumer- 
able instances  demonstrated  its  specific  curative  power.  The 
freshly  expressed  juice  of  this  creeping  plant  is  dropped  into 
the  somewhat  dilated  wound,  the  surrounding  parts  are 
repeatedly  rubbed  and  covered  with  the  bruised  leaves,  and 
the  juice  at  the  same  time  also  internally  taken.  It  is  effica- 
cious against  the  bites  of  the  most  venomous  serpents.  It  is 
also  used  as  a  prophylactic."2 

Turchetti  states  that  Guaco  locally  applied  destroys  the 
specific  property  of  the  pus  from  a  chancre,  and  prevents  the 
production  of  a  second  chancre  by  inoculation.  He  also 
claims  for  it  positive  curative  powers  in  syphilis.3 

Lindley  speaks  of  the  Guaco  as  follows4 :  "  Aristolochiaceae 
(Guaco).  -  The  Guaco  of  the  Caraccas,  reported  to  be  a 
powerful  remedy  for  the  bites  of  serpents,  is  said  by  Dr. 
Hancock  to  be  some  plant  of  this  genus." 

In  fatAllgemeineHomoeopathischeZeitung;*  in  a  letter  from 
Bordeaux  it  is  stated,  "A  Mexican  physician  has  sent  hither 
a  plant,  Houacou"  (evidently  the  same  as  Guaco),  "which  has 
proved  very  curative,  in  Mexico,  in  certain  very  severe  mal- 
adies possessing  great  similarity  to  cholera.  Our  physicians 
have  made  successful  experiments  with  it;  out  of  eight 
patients  to  whom  it  was  given,  six  were  cured.  *  *  A  few 
drops  administered  on  a  lump  of  sugar  restored  a  distinct 
pulse  to  a  patient  who  had  already  become  quite  pulseless." 

1  Travels,  Bohn's  edition,  vol.  ii.,  3  Schmidt's  Jahrbuch,  Bd.   101,  p. 

page  364.  1 68. 

*  Homceopathische  Vierteljahrschrift,  *  Flora  Medica,  page  344,  $  915. 

4>  39I~392-  6  Vol.  i.,  page  128,  December,  1832. 


REMARKS   ON   GUAO.  425 

In  the  Allgemeine  Homceopathische  Zeitung,1  reference  is 
made  to  an  article  by  Dr.  J.  G.  Houard,  of  Philadelphia,  in 
the  North  American  Journal  of  Homoeopathy?-  This  article  is 
a  translation  of  a  Spanish  pamphlet  on  Guaco  in  cholera.  It 
gives  no  other  name  than  Guaco  to  the  remedy  used  and  no 
description  of  the  plant  from  which  it  was  derived,  but  refers 
to  an  article  on  the  subject  by  Dr.  Chalmers,  an  allopathist, 
in  the  Diario  of  Havana. 

In  the  Zeitschrift  fur  Homozopathische  Klinik?  it  is  stated 
that  Guaco  was  recommended  in  cholera  by  Dr.  W. 
Valentin.  It  had  already  been  recommended  in  1853  by 
Otto,  of  Copenhagen,  for  gout,  asthma,  rheuma ;  by  Chabert, 
in  Mexico,  for  cholera,  and  in  1836  had  been  used  with  good 
effect  in  cholera,  by  Czeterkyn,  in  Poland.  In  1 840,  Jobst  pub- 
lished a  pamphlet  on  the  subject  giving  communications  from 
the  then  President  of  Venezuela,  Dr.  Vargas  of  Caraccas. 
According  to  the  latter,  Guaco  (in  form  of  tincture)  is  used  in 
Caraccas  in  the  following  diseases:  it  cures  the  bites  of 
poisonous  snakes;  of  the  scorpions;  prevents  hydrophobia ; 
antidotes  poisons ;  is  useful  in  relieving  pain  from  wounds 
resulting  from  falls  or  floggings  (it  would  be  valuable  in 
boarding-schools  and  on  the  plantation) ;  favors  menstrual 
flow  and  removes  constipation;  is  efficacious  against  affec- 
tions of  the  liver,  obstinate  ulcers;  is  said  to  prevent  and 
cure  cancer;  has  a  happy  effect  in  spasm  of  the  stomach  and 
consumption,  when  the  latter  depends  upon  menstrual  dis- 
turbances ;  cures  asthma ;  cures  tertian  and  all  fevers  com- 
plicated with  chill ;  is  a  powerful  anthelmintic ;  restores  the 
functions  of  the  stomach  in  feeble  persons,  and  stimulates  the 
circulation  ;  cures  megrim  radically  ;  alleviates  toothache4, — 
a  goodly  list  of  virtues  ! 

We  have  no  complete  proving  of  Mikania  guaco,  although 

1  Vol.  liv.,  page  6,  1857.  Materia  Medico,  i.,  ii. —  Jobst  "Ueber 

2  Vol.  ii.,  page  16.  Guaco.      Stuttgart,     1840.         Wien. 

3  Vol.  iii.,  page  94,  June,  1854.  Wochenschrift,  44." 
*Dierbach     Neue    Entdeckung,  in 


426  REMARKS   ON  GUAO. 

the  editor  of  the  Allgemeine  Homoeopathische  Zeitung  states 
that  one.  has  been  made  by  Dr.  Elb,  of  Dresden. 

Dr.  Elb  refers  to  this  in  an  article  on  "Spinal  Diseases"1 
(of  which  we  hope  soon  to  present  a  notice  to  the  reader)  in 
the  course  of  which  he  gives  the  pathogenesis  of  Guaco  in 
so  far  as  it  relates  to  symptoms  of  the  spinal  nervous  system. 


1 Allgemeine  Homccopathisehe  Zeitung,  61,  22  and  43. 


REMARKS  ON  SPIGELIA.1 


To  take  a  general  view  of  the  action  of  Spigelia  upon  the 
organism,  it  may  be  said  to  be  manifested  chiefly  upon  the 
nervous  system  of  animal  life.  Spigelia  is  eminent  among 
the  remedies  of  our  Materia  Medica  for  the  extent  to  which 
its  action  seems  to  be  exerted  upon  the  nerves  themselves 
or  their  envelopes.  Upon  the  substance  of  the  nervous 
centers,  however,  its  action  is  probably  very  slight. 

I.  Spigelia  excites  the  nerves  of  special  sense  in  a  marked 
degree,  and  this  without  any  clearly  defined  inflammatory 
affection  of  the  organs  of  special  sense.  In  this  regard,  it 
differs  from  Belladonna,  Rhus,  and  other  remedies  which 
excite  particularly  the  nervous  system  of  animal  life.  But 
there  is  an  exception  to  this  statement.  In  the  tissues  of 
the  eye  Spigelia  excites  inflammation,  its  symptoms  giving 
a  well-marked  picture  of  rheumatic  sclerotitis. 

Spigelia  exerts  a  marked  action  on  the  trifacial  nerve, 
producing  prosopalgia,  which  involves  the  orbit,  the  zygoma 
and  the  superior  maxilla  ;  also  upon  the  nerves  of  the  tongue; 
perhaps  also  upon  the  portio  dura.  The  prosopalgia  of 
Spigelia  is  distinguished  by  sticking,  burning  pains  with 
subsequent  swelling  and  soreness  of  the  parts  affected.  In 


,  N.  Y.,  March  26,  1877.  Dr.  Dunham  was  its  author,  and  it 

*     *     *     *     In  the  fifth  volume  of  should  appear  in  any  collection  of  his 

the  American   Homoeopathic    Review,  writings.     Dr.  Dunham's  reasons  for 

page   537,  is   an  article   on   Spigelia  wishing  it  to  appear  as  mine  were,  that 

purporting  to  have  been  read  by  me  he    was    writing    so    much    for    the 

in  October,  1864.     It  is   true  that  I  Review,  that  he   was   glad  to    have 

read  it,  and  by  request  of  Dr.  Dun-  some  other  name  appear  occasionally. 
ham  it  went  as  my  paper,  although  C.  W.  BOYCE. 

I  did  not  write  a  word  of  it. 


428  REMARKS   ON   SPIGELIA. 

this  respect  it  closely  resembles  the  prosopalgia  of  Colchi- 
cum,  from  which,  however,  it  is  distinguished  by  the  remark- 
able exaltation  of  the  special  senses  and  by  the  general 
nervous  erethism  and  excitement  and  intolerance  of  pain 
which  characterize  Spigelia,  whereas  Colchicum  on  the  other 
hand  has  an  equally  remarkable  tolerance  of  pain,  and 
patient,  enduring  disposition,  with  a  general  semi-paralyzed 
condition. 

2.  There  is  no  evidence  of  any  definite  modification  of 
the  organic  substance  of  any  part  of  the  body,  unless  such 
action  upon  the  pericardium  be  inferred  ex  usu  in  morbis. 

3.  The  sphere  of  action  of  Spigelia  is  not  extensive.     It 
embraces  the  nerves  of  animal  life  and  of  special  sense,  and 
the  fibrous,  and  perhaps  the  muscular,  tissues  of  the  heart  and 
of  the  smaller  extremities. 

The  effect  of  Spigelia  upon  the  heart's  action  seems  to  be 
due  to  a  morbid  condition  which  the  drug  excites  in  the 
pericardium,  and  hence  its  value  in  pericarditis. 

4.  The  pains  of  Spigelia  are  sticking,  tearing,  and  burn- 
ing pressing.     They  are  aggravated  by  motion  and  in  the 
afternoon  and  at  evening.     They  often  prevent  sleep.  There 
is  great  lassitude  and  heaviness  of  the  limbs.  ,  Great  sen- 
sibility of  the  whole  body  to  touch;    the  least  touch  on 
any  part  of  the  body  sends  a  shudder  through  the  whole 
frame. 

5.  There  is  no  marked  periodicity  in  the  symptoms. 

Let  us  now  examine  more  closely  the  different  parts  of  the 
body  chiefly  affected. 

Head.  There  is  vertigo  when  looking  down  and  when 
walking.  The  memory  is  impaired,  and  mental  effort  is  very 
irksome. 

The  headache  is  very  characteristic  and  presents  a  good 
picture  of  a  form  of  so-called  "nervous  headache."  In 
general,  the  sensations  are  dullness,  heaviness  and  pain  in 
the  head ;  the  pain  is  much  increased  by  shaking  or  jarring 
the  head,  as  by  walking,  especially  if  one  make  a  misstep, 


REMARKS   ON   SPIGELIA.  429 

or  cough  or  sneeze ;  by  moving  the  facial  muscles ;  by 
speaking  aloud  or  by  any  loud  noise,  as  well  as  by  touch  or 
by  a  bright  light.  These  things  increase  the  pain  so  that 
it  seems  as  though  the  head  would  burst ;  the  patient  is 
compelled  to  support  it  with  the  hand,  or  to  bind  it  around. 
(Here  we  have  headache  with  over-sensibility  of  the  senses 
of  sight,  hearing  and  touch,  with  relief  from  binding  the  head. 
These  symptoms  resemble  the  headache  of  Silicea,  which 
has  likewise  exaltation  of  the  special  senses  and  relief  from 
binding  up  the  head,  but  it  is  to  be  carefully  noted,  as 
characteristic,  that  the  relief  to  the  Spigelia  headache 
comes  from  the  pressure  of  the  bandage,  while  to  the  Silicea 
headache,  the  relief  is  from  the  warmth;  for  «warmth 
relieves  the  Silicea  headache,  while  it  rather  aggravates  the 
headache  of  Spigelia.) 

The  pains  are  a  heaviness  and  feeling  as  of  a  load  or 
weight  in  the  head ;  a  pressing  from  without  inward,  aggra- 
vated by  stooping  forward,  unless  the  forehead  is  supported 
by  the  hand ;  a  sensation  of  swashing  and  surging  of  the 
brain  within  the  cranium  (compare  China  and  Rhus  and 
Apis)  at  every  step,  or  on  the  least  motion,  or  when  speaking 
loudly,  and  very  severe  when  a  false  step  is  made  or  the 
body  is  jarred ;  relieved  tjy  repose.  This  swashing  sensation 
is  often  accompanied  by  a  tearing,  digging  pain  in  some  small 
well-defined  portion  of  the  head;  generally,  semi-lateral,  as, 
for  example,  in  the  left  parietal  region,  or  the  space  extend- 
ing from  the  left  occiput  to  the  left  forehead.  As  regards 
the  localities  affected,  the  pain  is  generally  circumscribed 
and  is  often  confined  to  one  side ;  more  frequently  the 
left. 

The  occiput  is  the  seat  of  many  pains  which  extend  into 
the  nape  of  the  neck  causing  stiffness  and  at  the  same  time 
restlessness.  In  the  forehead  and, in  the  frontal  protuber- 
ances we  find  pulsating  stitches;  pressure  from  without 
inward ;  boring  and  burning  pains ;  the  latter  are  probably 
superficial  and  seated  in  the  supra-orbital  nerve.  In  the 


430  REMARKS   ON   SPIGELIA. 

frontal  protuberances  tearing  pain  extending  into  the  eye 
and  aggravated  by  motion  of  the  globe  of  the  eye. 

In  the  temporal  region  we  find  pulsating  stitches,  pressure 
inward  and  burning,  extending  into  the  zygoma. 

We  pass  now  to  the  Eyes,  which  are  acted  upon  not  only 
as  regards  the  tissues,  especially  the  muscular  and  fibrous 
tissues,  but  also  as  regards  the  special  sense  of  vision. 

In  addition  to  the  affections  of  the  eye  proper,  we  find  in 
the  left  orbit  pressing  neuralgic  pains  extending  down  to  the 
zygoma  and  leaving  on  the  zygoma  a  tumor  which  is  sensi- 
tive to  the  touch. 

The  conjunctiva  is  moderately  inflamed.  There. is  moder- 
ate paki  as  if  sand  were  in  the  eye,  a  slight  secretion  of 
muco-pus  and  bland  lachrymation. 

The  affection  of  the  deeper  tissues  of  the  eyeball  is  shown 
by  the  dull  and  flat  aspect  of  the  eye,  the  supra-orbital  pains, 
redness  and  inflammation  of  the  sclerotic  with  ptosis,  pain 
in  eye  and  brow ;  the  eyeball  is  painful  when  moved  and 
feels  tense  as  if  too  large  for  the  orbit  (Paris  quadrifolia) ; 
sticking  pain  in  the  eye.  The  eye  is  painful  when  moved 
in  any  direction  (Bryonia),  an  intolerable  pressive  pain,  so 
great  that,  rather  than  endure  it,  the  patient,  when  desirous 
of  looking  from  side  to  side,  move,s  the  whole  head,  instead 
of  merely  the  eyeball.  Heat  and  burning  in  the  eyes. 

Vision.  The  sensibility  of  the  retina  is  increased,  inducing 
photophobia.  It  is  likewise  perverted,  causing  illusions,  as 
if  hairs  or  feathers  were  on  the  lashes,  and  these  illusions 
are  increased  by  wiping  the  eyes ;  sparks  and  a  sea  of  fire. 
The  pupils  are  dilated. 

The  sense  of  hearing  is  exalted  in  connection  with  the 
headache. 

In  the  zygomatic  region  of  the  left  side  of  the  face,  burn- 
ing or  tearing  pressive  pains  which  leave  a  dull  sensation  of 
swelling  as  the  pain  abates.  There  are  stitches  from  the 
upper  maxilla  to  the  vertex. 

We  pass  now  to  the  symptoms  of  the  thorax. 


REMARKS   ON   SPIGELIA.  431 

There  are  stitches  in  the -chest  in  various  parts;  and  on 
both  sides,  most  frequently  the  left.  These  stitches  are  gen- 
erally from  within  outward,  and  are  aggravated  by  respira- 
tion (most  by  inspiration)  and  by  motion.  They  occur 
under  the  nipple  of  either  side,  and,  on  the  left  side,  are 
directed  toward  the  scapula  and  left  arm. 

The  following  symptoms:  violent  stitch  in  the  left  side 
just  under  the  heart  recurring  periodically ;  stitch  in  the 
diaphragm  on  the  left  side,  so  violent  as  to  arrest  breathing  ; 
dull  stitches,  synchronous  with  the  pulse,  in  the  region  in 
which  the  heart's  impulse  is  felt ;  stitches  between  this  spot 
and  the  epigastrium  ;  —  these  symptoms,  together  with  those 
which  denote  modified  action  of  the  heart,  viz.  :  very  violent 
pulsation,  audible  to  the  patient  and  visible  to  the  by-stand- 
ers ;  violent  palpitation  and  anxiety ;  tremulous  motion  of 
the  heart ;  palpitation  increased  by  sitting  down  and  bend- 
ing forward,  and  by  deep  inspiration  and  retention  of  the 
breath ;  palpitation  as  soon  as  he  sits  down  after  rising  in 
the  morning,  and,  in  the  praecordial  region,  a  heavy  painful 
pressing  load  causing  constriction  and  anxiety  with  cutting 
and  griping  as  from  wind  in  the  abdomen  ; — these  symptoms 
all  clearly  point  to  an  affection  of  the  heart  and  pericardium, 
and,  in  such  diseases,  clinical  experience  has  shown  Spigelia 
to  be  of  exceeding  value. 

CLINICAL  INDICATIONS.  It  is  evident  from  our  hasty  and 
partial  review  of  the  symptoms,  that  Spigelia  may  be  clearly 
indicated  in  cases  that  would  come  under  the  following 
groups: 

i.  Headaches ;  generally  semi-lateral,  so-called  nervous; 
accompanied  by  great  exaltation  of  the  special  senses  (com- 
pare Silicea,  Conium);  aggravated  by  motion,  noise,  light  and 
thought ;  involving  generally  the  left  eye  and  orbit  without 
congestion  of  the  head.  In  such  affections  (if  attended,  as 
frequently,  by  nausea  and  vomiting,  they  resemble  "sick  head- 
aches ")  Spigelia  compares  with  Silicea,  Belladonna,  Apis, 
Ignatia,  Thuja,  Sanguinaria. 


432  REMARKS   ON   SPIGELIA. 

2.  In  Sclerotitis.     Also  in  nasal  catarrh  when  the  dis- 
charge is  chiefly  from  the  posterior  nares  into  the  pharynx, 
and  attended  by  neuralgic  affections  of  the  pharynx  and 
region  of  the  ear  and  lower  jaw,  provided  always  the  general 
symptoms  correspond. 

3.  Above  all,  in  acute  or  sub-acute  affections  of  the  heart 
which  present  symptoms  similar  to  those  of  Spigelia  above 
quoted,  it  is  an  invaluable  remedy ;  as  for  example,  in  acute 
pericarditis,    with   anxiety   and   weight    in   the   praecordia, 
stitches  through  the  heart  arresting  respiration,    oppressed 
and  accelerated  palpitation  so  forcible  as  to  be  audible  and 
visible,  and  excited  or  aggravated  by  change  of  position  or  by 
the  slightest  motion.     In  such  cases,  Spigelia  compares  with 
Aconite,   Bryonia,  Kalmia,  Lachesis,  Naja.     And  with  the 
new  remedy  Cactus  grandiflorus. 


DR.  HARLEY  ON  CONIUM  MACULATUM. 


The  idea  of  a  Materia  Medica  Pura — a  collection  of  the 
effects  of  drugs  upon  the  healthy — did  not  originate  with 
Hahnemann.  He,  himself,  quotes  several  of  his  prede- 
cessors— notably  Haller,  who  explained  and  urged  the 
necessity  of  such  a  collection,  as  the  only  means  of  acquiring 
an  exact  knowledge  of  the  relations  of  drugs  to  the  human 
organism,  and  a  possible  key  to  their  therapeutic  use.  But 
Hahnemann  was  the  first  physician  who  seriously  devoted 
a  large  part  of  his  life  to  the  labor  of  ascertaining  these 
effects,  and  making  such  a  collection.  Many  a  critic  has, 
to  his  own  satisfaction,  demolished  Hahnemann's  work,  and 
shown  the  fallacy  of  his  demonstration  of  the  value  of  prov- 
ing on  the  healthy.  And,  until  very  recently,  the  task 
of  systematically  developing  the  pure,  that  is  the  physiologi- 
cal, Materia  Medica  has  been  left  to  our  own  school  of 
medicine.  But  the  same  mysterious  mental  and  moral 
influences  which  have  "  drifted "  the  dominant  school  into 
admissions  of  the  (at  least  partial)  truth  of  the  law,  similia 
similibus  curantur ;  into  advocacy  of  the  single  remedy  (in 
theory  at  least) ;  and  into  the  concession  that  the  thera- 
peutic power  of  a  drug  is  not  necessarily  in  the  direct  ratio 
of  the  quantity,  have  recently  overtaken  prominent  physi- 
cians, especially  of  England ;  and  Sir  Thomas  Watson  has 
distinctly  pointed  to  a  pure  Materia  Medica  as  a  possible 
way  to  a  therapeutic  law,  and  an  escape  from  the  present 
chaos  of  therapeutics.  And  Dr.  John  Harley,  of  London, 
in  the  Gulstonian  Lectures  of  1868,  on  "The  Old  Vegetable 
Neurotics,"  has  given  us  an  installment  of  the  "  pure  Materia 
Medica"  of  the  future,  as  the  allopathists  understand  and 
29 


434      DR-  HARLEY  ON  CONIUM  MACULATUM. 

propose  to  construct  it.  His  work  presents  the  physiologi- 
cal action  and  therapeutic  use  of  Hemlock,  Opium,  Bella- 
donna and  Henbane,  alone  and  in  combination. 

It  is  worthy  of  our  most  thoughtful  study.  We  must 
not  allow  a  pardonable  feeling  of  satisfaction  that  the  oppo- 
nents who  would  have  overwhelmed  with  scorn  our  Materia 
Medica  Pura,  have  now  come  to  build  such  a  structure  for 
themselves  after  our  plan ;  nor  hug  ourselves  in  self-suffi- 
ciency because  they  disdain  to  use  the  materials  we  have 
fathered. 

While  we  have  labored  in  our  departments  of  Materia 
Medica  and  Therapeutics,  the  allopaths  on  their  side  have 
not  been  idle.  The  sciences  of  physiology,  pathology  and 
organic  chemistry  have,  through  their  industry,  made  won- 
derful advances,  and  now  all  the  resources  which  these 
sciences  afford  them  are  brought  to  assist  our  opponents 
in  their  physiological  provings  of  drugs.  It  behooves  us, 
with  minds  devoid  of  prejudice  and  conceit,  and  with  a 
teachable  spirit,  to  scrutinize  their  labors  and  canvass  their 
achievements,  that  we  may  profit  by  their  contributions 
to  useful  knowledge,  and  avoid  the  errors  into  which,  through 
an  erroneous  application  of  these  auxiliary  sciences,  they 
may  chance  to  fall. 

The  first  drug  treated  by  Dr.  Harley  is  the  Conium  mac- 
ulatum.  We  propose  to  give  a  summary  of  his  pathogenesis, 
and  his  views  of  the  therapeutic  uses  of  this  drug,  and  then 
to  give  a  parallel  summary  of  Hahnemann's  provings  and 
of  our  clinical  experience,  with  reflections  upon  the  similari- 
ties and  differences.  A  similar  treatment  of  the  other 
remedies  discussed  by  Dr.  Harley  will  follow. 

Some  remarks  in  the  preface  are  worthy  of  quotation. 
Dr.  Harley  says : 

"  My  object  throughout  has  been  to  ascertain,  clearly  and  definitely,  the 
action  of  the  drugs  employed  on  the  healthy  body  in  medicinal  doses,  from  the 
smallest  to  the  largest;  to  deduce  simple  practical  conclusions  from  the  facts 
observed ;  and  then  to  apply  the  drug  to  the  relief  of  the  particular  condi- 
tions to  which  its  action  appeared  suitable." 


DR.    HARLEY   ON   CONIUM    MACULATUM.  435 

A  homoeopathist  might  almost  have  written  this,  certainly 
the  first  section.  But  in  the  deduction  "of  simple  practical 
conclusions  from  the  facts  observed,"  the  door  is  opened  to 
hypothesis  and  error;  and  how  can  one  "apply  the  drug  to 
the  relief,"  etc.,  unless  one  possess  a  therapeutic  law  express- 
ing the  relation  between  such  "conditions"  and  the  patho- 
genetic  "  facts  observed  "  ?  Here  are  the  weak  points  of  Dr. 
Harley's  system.  Until  he  shall  have  a  therapeutic  law, 
other  than  the  general  rule,  "causa  sublata,  tollitus  effectus" 
he  will  be  unable  to  apply  the  remedy  therapeutically, 
except  through  the  intervention  of  two  hypotheses,  one  in 
pathology,  to  account  for  the  symptoms  of  the  patient,  and 
the  other  in  pathogenesy,  to  explain  the  phenomena  pro- 
duced in  the  drug-proving;  and  the  introduction  of  hypoth- 
eses into  a  scientific  induction  makes  way  for  error. 

Dr.  Harley  devoted  much  time  to  an  examination  of  the 
relative  value  of  the  different  officinal  preparations  of  Conium, 
most  of  which  he  regarded  as  destitute  of  medicinal  power. 

Discarding  the  Tinctura  conii  fructus  the  Tinctura  conii 
(dried  leaf),  and  the  Extractum  conii,  of  the  London 
Pharmacopoeia,  as  positively  or  comparatively  inert,  he 
describes  the  mode  of  making  the  Succus  conii,  which  he 
regards  as  a  uniform  and  very  active  preparation.  We  may 
say,  briefly,  that  his  process  is  substantially  the  same  as  that 
employed  by  Messrs.  H.  M.  Smith  &  Brother,  the  well- 
known  Homoeopathic  Pharmaceutists  of  New-York.  Pereira 
wrote  in  1858:  "In  the  present  state  of  uncertainty  with 
respect  to  the  real  physiological  operations  of  Hemlock,  it  is 
obviously  impossible  to  lay  down  indications  for  its  use 
which  can  be  much  relied  on."  Dr.  Harley  proved  Conium 
first  on  himself  and  says  :  "  Having  assured  myself  of  the 
effects  of  Hemlock  in  my  own  person,  I  have  thus  been  able 
to  fully  appreciate  its  operations  in  others,  and  proceed  much 
more  boldly  than  I  could  have  done  without  such  personal 
knowledge."  It  would  be  a  satisfaction  to  add,  "more 
intelligently  "  also. 


436      DR.  HARLEY  ON  CONIUM  MACULATUM. 

"  Physiological  Action  of  Hemlock, — The  first  effect  of  Hemlock  is  a  depres- 
sion of  the  motor  function;  and  its  last  is  the  complete  obliteration  of  all 
muscular  motion  derived  from  the  cerebro-spinal  motor  tract. 

"After  taking  3  iij-  of  the  Succus  conii,  I  set  out  walking;  and  three-fourths 
of  an  hour  after  the  dose  I  felt  a  heavy,  clogging  sensation  in  my  heels. 
There  was  a  distinct  impairment  of  motor  power.  I  felt,  so  to  speak,  that 
'the  go  '  was  taken  out  of  me.  It  was  not  that  I  felt  fatigue  just  then,  but  it 
seems  as  if  a  drag  was  suddenly  put  upon  me,  and  that  it  would  have  been 
impossible  to  walk  fast  if  urged  to  do  so.  After  walking  about  a  mile  up-hill 
this  sensation  was  very  decided,  and  on  putting  a  foot  on  the  scraper  at  the 
door  the  other  leg  was  shaky,  and  felt  almost  too  weak  to  support  me.  My 
movements  appeared  clumsy  to  myself,  and  it  seemed  necessary  that  I  should 
make  an  effort  to  control  them.  At  the  same  time  there  was  a  sluggishness  of 
the  adaptation  of  the  eye.  My  vision  was  good  for  fixed  objects ;  but  when  an 
uneven  object  was  put  in  motion  before  the  eyes,  there  was  a  haze  and  dimness 
of  vision,  producing  a  feeling  of  giddiness.  The  pulse  and  pupils  were  unaf- 
fected. These  were  the  whole  of  the  effects;  and,  after  continuing  for  an  hour, 
they  rapidly  disappeared  and  left  me  in  the  possession  of  my  usual  vigor. 

"2.  If  a  strong,  active  individual  take  five  or  six  drachms  of  the  Succus  on 
getting  up  in  the  morning,  and  start  off  for  a  long  -walk,  he  will  be  overtaken  in 
the  course  of  half  or  three-quarters  of  an  hour  with  a  feeling  of  general  tired- 
ness, and  a  special  weakness  of  the  knees,  as  if  he  had  been  regularly  tired  out 
by  walking  all  day  to  the  full  extent  of  his  powers.  If  he  be  unusually  active 
and  strong  he  will  not,  perhaps,  yield  to  the  inclination  to  rest,  but  will  proceed 
slowly  on  his  way,  feeling  a  strange  lightness  and  powerlessness  of  the  legs, 
with  a  tendency  to  drop  forward  on  his  knees.  This  will  be  associated  with 
some  giddiness,  and  a  feeling  of  heaviness  over  the  eyes.  At  first  the  feeling 
of  languor  will  be  most  oppressive,  but  it  will  soon  become  more  tolerable;  and 
if  he  should  continue  the  journey  for  an  hour,  he  will  find  that  the  feeling  of 
fatigue  has  by  this  time  nearly  passed  off.  In  the  course  of  another  hour  he 
will  be  as  active  as  ever. 

"  3.  The  following  were  the  effects  produced  in  my  own  person  during  a 
period  of  rest,  and  they  contrast  well  with  the  foregoing : 

"  Three-quarters  of  an  hour  after  taking  five  drachms  and  a  half  of  Succus 
conii,  on  raising  my  eyes  from  the  object  on  which  they  had  been  fixed  to  a 
more  distant  one,  the  vision  was  confused,  and  a  feeling  of  giddiness  suddenly 
came  over  me.  That  these  symptoms  were  due  to  impairment  of  power  in  the 
muscular  apparatus  employed  in  the  adaptation  of  the  eye,  was  obvious  to  me ; 
for,  so  long  as  my  eyes  were  fixed  on  a  given  object,  the  giddiness  disappeared, 
and  the  definition  and  capacity  of  vision  for  the  minutest  objects  were  unim- 
paired. But  the  instant  that  I  directed  the  eyes  to  another  object,  all  was  haze 
and  confusion,  and  I  felt  giddy ;  and  in  order  to  recover  my  vision  and  dismiss 
the  sense  of  giddiness,  it  was  necessary  to  lay  hold  upon  some  object,  as  it  were, 
with  my  eyes,  and  rest  them  securely  upon  it.  It  was  clear  to  me  that  the 
adjusting  muscular  apparatus  of  the  eye  was  enfeebled,  and  its  contractions  so 
sluggishly  performed  that  they  could  no  longer  keep  pace  with  the  more  active 
movements  of  the  external  muscles  of  the  eyeball. 


DR.  HARLEY  ON  CONIUM  MACULATUM.      437 

"Within  ten  minutes  of  the  appearance  of  this  disorder  of  vision  a  general 
muscular  lethargy  affected  me,  and  the  eyelids  felt  as  heavy  as  if  they  were 
oppressed  with  the  deepest  drowsiness.  The  pupils  were  considerably  dilated. 
I  sat  down  to  note  these  observations,  but,  being  afraid  to  maintain  this  posture 
lest  the  rapidly  increasing  muscular  lethargy  should  get  the  better  of  me,  I 
rose  up  again  and  tried  to  shake  it  off.  An  hour  and  a  quarter  after  taking  the 
dose  I  first  felt  decided  weakness  in  my  legs.  The  giddiness  and  diminution  of 
motor  power  continued  to  increase  for  the  next  fifteen  minutes.  An  hour  and 
a  half  after  taking  the  dose  these  effects  attained  their  maximum,  and  at  this 
time  I  was  cold,  pale  and  tottering.  The  pulse,  which  had  been  emotionally 
excited  by  the  sudden  accession  of  the  foregoing  symptoms,  was  now  sixty- 
eight,  quite  regular,  and  of  undiminished  force  and  volume.  The  legs  felt  as 
if  they  would  soon  be  too  weak  to  support  me.  There  was  a  positive  diminu- 
tion of  voluntary  power  in  every  part  of  the  muscular  system,  and  this  nearly 
amounted  to  complete  paralysis  as  far  as  the  hamstring  and  levator  palpebrse 
muscles  were  concerned.  At  one  time  the  greatest  exertion  was  required  to 
elevate  the  eyelids.  The  mind  remained  perfectly  clear  and  calm,  and  the 
brain  active  throughout;  but  the  body  seemed  heavy  and  well-nigh  asleep. 
After  continuing  for  about  half  an  hour  at  their  maximum,  the  symptoms 
began  rapidly  to  decline,  and  within  three  hours  and  a  half  after  taking  the 
dose  they  had  totally  disappeared.  **#*»# 

"A  delicate  young  woman,  of  inactive  habits,  took  four  drachms  of  the 
Succus.  Twenty  minutes  afterward,  and  while  attending  to  her  usual  duties, 
she  experienced  nausea  and  giddiness.  She  dropped  an  inkstand  which  she 
was  holding  in  her  hand,  and  was  unable  to  walk,  and  she  was  placed  in  the 
recumbent  posture.  These  symptoms  came  on  with  alarming  swiftness,  and 
the  pulse  went  up  to  one  hundred  and  twenty-six  from  emotional  excitement  (?) ; 
but,  in  a  few  minutes  the  heart  regained  its  usual  quietude,  and  she  remained 
perfectly  comfortable  and  calm,  but  without  power  to  move  the  arms  or  legs. 
An  hour  after  taking  the  medicine  there  was  nearly  complete  muscular  paraly- 
sis ;  the  eyelids  were  closed,  the  pupils  widely  dilated,  and  the  mind  clear, 
calm  and  active,  and  she  expressed  herself  quite  comfortable.  She  tried  persever- 
ingly  to  raise  the  eyelids  when  I  requested  her  to  do  so,  but  she  was  quite  unable 
to  separate  their  margins.  The  pulse  and  respiration  were  normal;  the 
surface  warm.  At  the  end  of  an  hour  these  symptoms  passed  off,  and  after 
three  hours  she  had  completely  recovered  her  activity  and  resumed  her  duties. 

The  next  day  she  complained  of  slight  wearisome  pain  in  the  muscles  of  the 
legs  **#*»»*#** 

"I  proceed  now,"  continues  Dr.  Harley,  "to  consider  in  detail  the  action  of 
Conium  upon  the  nervous  system.  The  earliest  indications  of  the  operation  of 
the  medicine  are  invariably  those  that  arise  from  the  depression  of  the  motor 
function  of  the  third  pair  of  nerves.  They  are  giddiness,  the  sensation  of  a 
heavy  weight,  depressing  the  eyelids,  or  actual  ptosis;  a  dull,  lazy  or  fixed 
expressionless  stare,  like  that  of  a  drunken  person ;  dilatation  of  the  pupils. 
After  moderate  doses,  the  interference  of  vision  is  only  such  as  results  in 
haziness,  as  if  a  thin  film  of  transparent  vapor  were  floating  between  the  eye 
and  the  object.  *  *  *  It  occurs  independently  of  any  dilatation 


438  DR.    HARLEY    ON   CONIUM   MACULATUM. 

of  the  pupils,  and  is  compatible  with  good  definition  for  fixed  objects.  It  is 
due  to  imperfect  adjustment  of  the  refracting  media  of  the  eye  from  partial 
paralysis  of  the  ciliary  branches  of  the  third  nerve.  It  is  through  these  minute 
branches  that  the  individual  first  becomes  conscious  of  the  effects  of  the 
Hemlock,  and  if  he  should  be  reading  at  the  time  he  will  suddenly  find  the 
occupation  fatiguing,  and  very  soon  afterward  it  may  be  impossible,  and  he 
will  be  glad  to  close  the  eyes  to  relieve  himself  of  the  symptom,  and,  as  the 
muscular  lethargy  begins  to  be  felt,  content  to  lie  perfectly  still,  as  if  asleep. 

"  In  full  doses  the  depressing  influence  involves  the  other  branches  of  the 
nerve,  and  the  lazy  movements  of  the  eyeball,  or  dull,  fixed  and  occasionally 
•divergent  stare,  indicate  the  partially  paralyzed  condition  of  the  external 
muscles  of  the  eyeball;  while  more  or  less  drooping  of  the  upper  lids  expresses 
a  similar  condition  of  the  levator  palpebrse. 

"  Double  vision,  from  inability  to  maintain  the  convergence  of  the  optic  axis, 
excepting  as  a  very  evanescent  effect,  is  a  comparatively  rare  result  of  the 
action  of  Hemlock.  I  have  only  observed  it  in  a  few  persons.  In  one  of 
these,  a  delicate  invalid,  confined  by  weakness  and  ovarian  disease  chiefly  to 
the  recumbent  position,  two  drachms  of  the  Succus  conii  produced  full  effects, 
accompanied  by  double  vision.  This  was  a  constant  symptom;  it  came  on 
half  an  hour  after  taking  the  medicine,  and  lasted  twenty  minutes. 

"  After  having  taken  the  Hemlock  for  six  months,  she  told  me,  as  often  as  I 
happened  to  see  her  during  the  operation  of  the  medicine,  that  she  saw  each 
object  in  the  room  double,  that  my  eyes  were  also  doubled,  and  that  she  felt  as 
if  she  were  squinting. 

"Dilatation  of  the  pupil  occurs  usually  after  only  very  large  doses,  and  then 
it  is  often  but  slight,  and  only  observable  in  a  subdued  light,  the  excitement  of 
strong  light  overcoming  the  tendency  to  dilate,  just  as  the  exertion  of  a  strong 
will  strengthens  for  a  time  an  enfeebled  limb. 

"  The  absence  of  any  preponderating  action  of  the  muscles,  supplied  by  the 
fourth  and  sixth  pairs  of  nerves,  shows  that  they  are  equally  affected  with  the 
third  pair. 

"A  proportionate  diminution  of  power  is  also  observed  in  the  muscles 
supplied  by  the  motor  branches  of  \hz  fifth  and  seventh  pairs.  The  contractile 
power  of  the  m.  orbicularis,  in  particular,  is  distinctly  weakened. 

"  Upon  the  eighth  pair  the  action  of  Conium  is  not  very  apparent  in  a  state  of 
health ;  but  in  the  spasmodic  affections,  arising  from  irritation  of  this  nerve,  its 
influence  is  very  decided. 

"As  to  the  hypoglossal  nerve,  I  have  never  observed  any  decided  loss  of 
voluntary  power  in  the  tongue  during  the  action  of  Conium,  unless,  as  in 
chorea,  some  derangement  of  this  center  pre-existed.  ***** 

"In  the  absence  of  irritation,  functional  or  lesional,  it  is  equally  difficult  to 
recognize  any  particular  influence  upon  the  spinal  cord.  Hemlock  affects  the 
motor  function  of  this  part  of  the  nervous  system  last  of  all,  and,  short  of  a 
poisonous  dose,  it  does  not  interfere  with  its  motor  activity,  or  reflex  function 
as  it  is  called,  in  any  appreciable  degree.  *  *  *  *  *  *  * 

"  When,  however,  there  is  a  morbid  excitability  of  the  reflex  function  of  the 
spinal  cord,  the  influence  of  Conium  in  subduing  it  is  powerful  and  direct. 


DR.  HARLEY  ON  CONIUM  MACULATUM.     439 

"  Conium,  then,  in  a  state  of  health,  and  in  the  fullest  medicinal  doses  that 
we  can  venture  to  give,  exerts  its  power  chiefly,  if  not  exclusively,  upon  the 
motor  centers  within  the  cranium.  And  of  these  the  corpora  striata,  of  course, 
are  the  parts  principally  affected. 

"  Excepting,  then,  the  reflex  action  of  the  cord,  the  whole  motor  function  of 
an  individual,  under  the  full  influence  of  Conium,  is  actually  asleep ;  and  this  is 
the  simplest  view  that  we  can  take  of  the  physiological  action  of  Hemlock.  It 
is  to  the  corpora  striata,  to  the  smaller  centers  of  motion,  and  to  the  whole  of  the 
motor  tract,  precisely  what  Opium  is  to  the  brain  of  a  person  readily  influenced 
by  its  hypnotic  action;  and  just  as  Opium  tranquilizes  and  refreshes  the  over- 
excited and  weary  brain,  so  does  Conium  soothe  and  strengthen  the  unduly 
excited  and  exhausted  centers  of  motor  activity.  *  *  *  *  * 

"  The  influence  of  Conium  appears  to  be  in  proportion,  not  to  the  muscular 
strength  of  the  individual,  but  to  his  motor  activity.  *  *  *  A  dull,  inactive 
child  requires,  to  produce  a  given  effect,  only  half  the  quantity  that  a  lively, 
active  one  does." 

This  observation  is  in  conformity  with  the  law ;  the  more 
similar  the  symptoms  the  smaller  the  dose. 

"  Upon  the  cerebrum,  Hemlock  is  powerless.  I  have  never  been  able  to 
recognize  the  least  narcotic,  nor  directly  hypnotic,  effects. 

"  Like  the  cerebrum,  the  sensory  part  of  the  nervous  system  is  altogether 
unaffected  directly  by  the  action  of  Conium.  Its  anodyne  power  in  certain 
diseases  may  be  fairly  attributed  to  muscular  relaxation  in  the  diseased  parts 
rather  than  to  a  direct  influence  upon  the  sensory  nerves.  *  *  * 
Of  its  anodyne  influence  upon  the  facial  branches  of  the  fifth  nerve,  I  have 
been  unable  hitherto  to  obtain  other  than  very  doubtful  evidence.  *  * 

I  think  that  we  may  trace  the  anydone  influence,  which  Hemlock  undoubtedly 
exercises  over  the  sensory  branches  of  the  fifth  nerve,  to  the  power  that  it 
possesses  of  calming  the  general  irritability  of  the  motor  centers.  *  * 
Conium  has  no  influence  upon  the  circulating  organs,  upon  the  secretions  or 
excretions,  or  directly  upon  nutrition.  Its  influence  upon  the  sexual  functions 
is  traceable  to  a  direct  action  upon  the  spinal  cord." 

After  thus  describing  the  physiological  action  of  Conium, 
Dr.  Harley  discusses  its  therapeutic  value,  giving  examples 
which  comprise  all  the  cases  in  which  he  has  used  Hemlock 
alone.  He  gives  the  following  general  conclusion  :  "Hemlock 
given  in  doses  which  fall  far  short  of  producing  its  proper 
physiological  action,  is  useless  in  the  treatment  of  diseases 
for  which  it  is  adpated."  The  homceopathist  will  perceive 
that  Dr.  Harley  comes  to  this  conclusion,  because  he  regards 


440      DR.  HARLEY  ON  CONIUM  MACULATUM. 

and  uses  Hemlock  as  "adapted"  only  to  cases  to  which  it  is 
enantiopathic. 

"  In  selecting  Hemlock  as  a  remedy  in  the  treatment  of  nervous  diseases, 
*  *  *  we  must  be  guided  by  that  simple  view  of  its  physiological 
action  which  I  have  now  so  fully  stated ;  and  then  the  only  question  to  be  pro- 
posed will  be,  is  there  irritation,  direct  or  reflex,  of  the  motor  centers  ?  If 
there  be,  Conium  is  the  appropriate  and  hopeful  remedy." 

The  homceopathist  will  ask :  May  there  not  be  many 
varieties  of  such  irritation,  varieties  in  kind,  extent,  and 
complication  ?  And  again  :  May  not  the  results  of  irrita- 
tion occurring  in  individuals  of  different  idiosyncrasy  be 
very  various  ?  And  are  all  such  varieties  to  find  their 
"  appropriate  and  hopeful  remedy  "  in  Conium  ?  How  con- 
stantly, then,  will  Conium  be  prescribed  in  our  daily  prac- 
tice ;  for  how  few  cases  fail  to  present  "  irritation,  direct  or 
reflex,  of  the  motor  centers  "  ! 

Dr.  Harley  gives  examples  of  the  beneficial  action  of 
Conium  in  cases  presenting  tendencies  to  convulsions.  A 
case  of  epilepsy  was  ameliorated.  Muscular  tremor  and 
chorea  were  cured;  but  the  rapidity  of  the  cure  in  the 
six  cases  of  chorea  is  not  such  as  a  homoeopathic  physician 
would  consider  creditable.  Dr.  Harley  does  not  ascribe 
cKorea  to  a  perversion  of  the  co-ordinating  function.  He 
doubts  if  there  be  such  a  function,  and  regards  chorea  as 
due  to  "  an  undue  excitability  of  the  motor  centers,  which 
throw  off  impressions  so  rapidly  that  the  will  is  puzzled  to 
control  them."  If  this  be  all  that  chorea  is,  Conium 
according  to  Dr.  Harley,  should  cure  every  case.  As  a 
matter  of  fact,  we  see  a  great  variety  of  symptoms  in  differ- 
ent cases  of  chorea,  and  similarly  we  see  great  varieties 
in  the  modifications  which  different  medicines  produce  in 
the  motor  functions.  Dr.  Harley's  (the  physiological)  method 
takes  no  account  of  such  varieties.  It  is  not  broad  enough 
for  the  facts  of  nature  with  which  it  assumes  to  deal. 

He  proposes  to  use  Conium  in  tetanus,  and  has  employed 
it  in  spasm  of  the  oesophagus  and  stomach ;  in  the  globus 


DR.  HARLEY  ON  CONIUM  MACULATUM.      44! 

hystericus ;  in  spasmodic  cough,  laryngismus  stridulus,  and 
pertussis ;  in  paraplegia,  and  in  concussions  of  the  spine, 
and  in  exhaustion  and  irritability  of  the  sexual  organs. 

He  speaks  highly  of  Conium  as  a  remedy  in  inflammatory 
diseases  of  the  eye,  and  gives  six  cases  of  "strumous 
inflammation  of  the  conjunctiva,  more  or  less  involving 
the  cornea  and  iris,  successfully  treated  by  Conium  alone 
and  unaided  by  external  applications.  The  speedy  relief 
from  the  photophobia,  lachrymation,  and  spasm  of  the 
orbicularis  has  often  surprised  me."  He  accounts  for  its 
action  on  the  ground,  that  "in  producing  complete  mus- 
cular relaxation  it  acts  beneficially  in  relieving  pain  and 
tension,  and  thus  removing  irritation."  It  is  difficult  to 
believe  that  strumous  ophthalmia  (keratitis)  depends  on 
"spasm  of  the  orbicularis  and  corrugator  supercilii."  Con- 
junctivitis palpebralis,  at  least,  is  well  established,  and,  in 
most  cases,  destructive  keratitis  has  set  in  before  the  spasm 
becomes  a  prominent  symptom.  Dr.  Harley  gives  an 
excellent  case  of  this  disease  cured  in  three  months  by  two 
drachm  doses  of  Conium  every  second  day.  I  shall  give 
the  record  of  a  severe  case  cured  in  one  month  by  a  few 
doses  of  Conium200. 

In  cancer  he  considers  Hemlock  a  palliative,  in  that  it 
allays  muscular  spasm,  and  thus  mitigates  pain.  In  glandu- 
lar enlargements,  and  in  cerebral  diseases,  he  has  found  no 
benefit  from  Conium. 

In  these  citations  we  have  given  a  fair  and  full  view  of 
Dr.  Harley's  provings  of  Conium,  and  experience  in  its 
therapeutic  use.  He  admits  its  imperfectness,  but  seems 
to  regard  this  as  relating  to  extent  rather  than  to  method  or 
principles. 

Let  us  now  reflect  a  moment  on  this  method  of  regarding 
and  stating  the  physiological  effects  of  a  drug.  •  How  satis- 
factory it  appears  to  have  the  entire  action  of  a  drug  con- 
densed in  one  crisp  generalization  like  this  of  Dr.  Harley, 
instead  of  having  to  read  page  after  page  of  symptoms 


442  DR.    HARLEY   ON   CONIUM    MACULATUM. 

arranged  in  anatomical  order !  And  how  easy  seems  the 
application  of  such  a  generalization  to  therapeutics,  possess- 
ing, as  we  do,  the  law.  Let  us  not,  however,  be  led  astray 
by  such  fascinations !  Such  generalizations  are  not  possible 
in  the  present  state  of  medical  science.  So  long  as  there 
occur  in  the  healthy  body,  phenomena  physical,  mental  or 
psychical,  which  we  cannot  fully  explain  by  known  physio- 
logical processes — and  there  are  thousands ;  so  long  as  the 
sick  present  symptoms  physical,  mental  or  psychical,  which 
we  cannot  account  for  by  well-understood  pathological  proc- 
esses— and  their  name  is  legion, — so  long  will  it  be  impos- 
sible to  reduce  phenomena  and  symptoms  respectively  to  a 
general  physiological  or  pathological  formula.  And,  con- 
versely, whoever,  in  his  therapeutic  philosophy  includes 
only  such  phenomena  of  symptoms  as  he  can  thus  explain 
and  account  for,  disregarding  or  overlooking  all  others, 
binds  therapeutics  to  the  slow  chariot- wheels  of  physiology 
and  pathology,  and  forbids  that  more  rapid  progress  of  this 
practical  department  of  medicine  which  is  possible  under  a 
therapeutic  law  that  turns  to  account  every  phenomenon  of 
pathogenesy,  and  every  symptom  of  the  patient.  This  will 
appear  more  clearly  when  we  come  to  study  the  homoeo- 
pathic proving  of  Conium. 


CONIUM  MACULATUM. 


The  following  remarks  are  based  upon  the  proving  pub- 
lished by  Hahnemann  in  the  "Chronic  Diseases,"  volume 
iii.,  second  edition : 

General  Analysis,  i.  The  action  of  Conium  upon  the 
vital  power  is  very  peculiar.  It  depresses  the  sensorium, 
weakening  the  memory,  producing  mental  lassitude  and  dull- 
ness, with  difficulty  in  expressing  one's  ideas;  and  yet, 
under  its  action,  the  special  senses  are  abnormally  acute,  at 
least  those  of  sight,  smell  and  hearing.  The  pulse  is 
enfeebled  and  irregular,  but  in  no  other  way  does  the  invol- 
untary muscular  system  appear  to  be  affected.  Power  of 
locomotion  is  not  impaired,  but  extreme  lassitude  and 
debility  are  manifest  throughout  the  body,  indisposing  to 
physical  exertion.  Clonic  spasms  of  the  muscles  of  the  face, 
arms  and  hands,  have  been  observed. 

2.  There  is  not  much  in  our  proving  of  Conium  that 
shows  a  marked  action  on  the  organic  substance,  never- 
theless Hahnemann's  acute  observation  enabled  him  to  per- 
ceive indications  for  a  clinical  application  of  it,  which  has 
demonstrated  that  it  must  possess  the  power  to  alter  pro- 
foundly the  structure  of  various  parts  of  the  body ;  as  for 
example,  the  glandular  substance,  the  substance  of  the 
cornea,  the  skin,  and  the  uterus  and  its  appendages. 

Among  the  symptoms  of  Conium,  those  of  the  disposition 
are  very  well  marked  and  characteristic.  The  prover  is  much 
depressed  and  disposed  to  weep,  yet  easily  aroused  to  anger, 
averse  to  companionship,  and  inclined  to  shun  society,  yet 
dreads  to  be  alone.  Sexual  desire  in  the  male  is  easily 
aroused,  even  by  the  mere  presence  of  women,  yet  the 


444  CONIUM    MACULATUM. 

sexual  organs  appear  so  much  enfeebled  that  seminal  emis- 
sions take  place  under  these  circumstances,  and  sometimes 
without  erection.  In  like  manner  in  the  female,  the  menses 
appear  too  early,  but  are  scanty,  the  flow  being  accompanied 
by  many  accessory  symptoms,  among  which  extreme  ten- 
derness of  the  mammary  glands  is  very  characteristic. 

The  muscular  lassitude  is  most  marked  in  the  early  morn- 
ing ;  the  arms  and  legs  feel  tired  and  sore,  the  knees  tremble, 
and  after  a  short  walk  the  prover  is  exhausted  and  must  lie 
down.  The  symptoms  generally  are  worse  at  night,  espe- 
cially the  cough,  and  the  pains  are  worse  during  repose. 

With  these  general  remarks,  we  pass  to  a  more  detailed 
consideration  of  the  symptoms,  in  anatomical  order. 

Conium  produces  the  following  effects  upon  the  mind  and 
disposition :  Depression,  sadness,  under  which  tears  come 
easily,  excessive  anxiety,  or  else  unnatural  indifference,  with 
depression.  The  prover  seems  sunk  in  thought,  and  is 
apprehensive  respecting  the  present  or  the  future.  Dislike  of 
society,  and  yet  a  dread  to  be  alone ; — this  apparently  incom- 
patible symptom  reminds  one  of  the  incongruities  of  hysteria, 
and  has  been  very  often  verified  in  practice.  Hahnemann 
urges  upon  us  the  importance  of  attending  to  the  symptoms 
of  the  mind.  This  is  a  characteristic  mind-symptom  of 
Conium.  Upon  the  sensorium  it  produces  vertigo,  which  is 
experienced  when  rising  from  the  recumbent  or  sitting 
posture,  when  rising  after  stooping ;  or,  on  the  other  hand, 
when  going  down-stairs ;  and  it  is  often  worse  when  lying 
down — a  symptom  which  is  noteworthy  in  connection  with 
Dr.  Harley's  speculations  upon  the  physiological  action  of 
Conium.  Memory  seems  to  be  enfeebled,  as  is  likewise  the 
power  of  comprehending  what  one  reads,  or  of  correctly 
expressing  one's  self.  Nevertheless,  Hahnemann  remarks 
that  the  provers  of  Conium  are  unusually  susceptible  to  the 
action  of  wine  or  alcohol,  and  we  shall  see  that  the  special 
senses  are  abnormally  acute  under  its  influence. 

Of  the  head  symptoms,  we  remark,  first,  as  to  the  charac- 


CONIUM   MACULATUM.  445 

ter  of  the  pains :  an  aching  pain,  which  is  sometimes  confined 
to  one  side  of  the  head,  feels  like  a  heavy  downward  press- 
ure, and  is  increased  by  motion  of  the  eyes ;  sometimes  in 
the  occiput,  like  a  heaviness  when  one  sits  leaning  forward; 
sometimes  in  the  temples  and  over  the  eyes,  like  a  pressure 
from  within  outward.  Second.  Tearing  pains,  as  a  morning 
headache,  as  if  the  brain  were  torn.  Third.  A  drawing 
pain  in  the  forehead  and  temples,  and  a  piercing  pain  from 
within  outward.  The  headaches  are  generally  worse  during 
motion  and  from  a  sudden  jar  or  shock,  such  as  a  false  step, 
which  sometimes  produces  a  digging  pain  in  the  head ;  and 
the  brain  seems  to  be  sensitive,  speaking  and  noise  producing 
an  unpleasant  concussion  in  it. 

In  the  eyes  heat  and  burning ;  itching  and  piercing  pains 
in  the  canthi,  or  a  smarting  as  if  some  acrid  substance  had 
been  introduced  into  the  eye.  In  the  eyeball,  aching, 
increased  by  reading,  and  in  the  evening,  by  closing  the  eye. 
The  white  of  the  eye  is  sometimes  red  and  inflamed ;  the 
tears  are  abundant,  overflowing  the  lids,  and  are  very  acrid. 
The  lids  are  thick  and  inflamed,  pustules  appearing  upon 
them.  The  special  sense  is  variously  affected.  Photophobia 
is  among  the  symptoms.  A  short-sighted  prover  was 
enabled  to  see  much  farther  than  usual.  Transient  blind- 
ness, or  dimness  of  vision,  was  noted  by  others;  while 
others  describe  appearances  as  if  threads  or  white  clouds 
or  luminous  spots  were  moving  in  front  of  the  eyes,  and  as 
if  when  reading,  the  lines  upon  the  printed  page  moved  up 
and  down.  These  eye-symptoms,  produced  upon  the 
healthy,  afford  us  a  more  valid  reason  for  using  Conium 
in  strumous  ophthalmia  than  Dr.  Harley's  physiological 
explanation  of  its  action  could  do. 

In  the  inner  ear,  sharp  shocks  from  within  outward  were 
felt  when  swallowing,  and  piercing  pains  and  aching ;  pain- 
ful tension  behind  the  ear  and  piercing  pains  in  the  mastoid 
process.  The  cerumen  was  blood-red  in  color ;  the  special 
sense  abnormally  acute,  and  painfully  so,  every  noise  caus- 


446  CONIUM    MACULATUM. 

ing  the  prover  to  start.  The  provers  complained  of  rushing, 
roaring  and  ringing  noises  in  the  ear,  with  throbbing,  as  of 
the  pulse;  when  blowing  the  nose  the  ears  feel  as  if 
obstructed. 

The  sense  of  smell  is  very  acute,  perhaps  perverted ;  a 
prover -stating  that  he  seemed  to  smell  tar,  as  though  it  were 
in  the  posterior  nares. 

On  the  lips,  vesicles  appear  near  the  vermilion  border, 
and  are  very  sore. 

Drawing  pains  and  fine  stitches  in  the  gums  and  teeth. 
The  toothache  is  aggravated  by  cold  food  ;  the  gums  bleed 
easily,  and  the  teeth  feel  as  if  they  were  loose ;  the  tongue 
is  dry  and  swollen ;  deglutition  difficult  and  painful,  from 
soreness  of  the  throat.  Speech  is  difficult,  probably  for  the 
above  reasons. 

Appetite  is  diminished ;  the  taste  is  not  blunted,  but 
provers  complain  of  a  sour,  foul  or  bitter  taste,  especially  in 
the  throat  Eructations  occur,  sometimes  tasteless,  some- 
times sour  or  offensive,  or  tasting  of  the  food;  sometimes 
they  are  incomplete  and  produce  pain  in  the  stomach. 
Nausea  and  vomiting  of  mucus  occur,  sometimes  early  in  the 
morning,  sometimes  after  eating,  sometimes  toward  evening. 

Digestion  is  much  disordered,  as  we  see  by  the  symptoms 
which  occur  soon  after  eating  ;  rapid  distension  of  the  abdo- 
men after  eating  only  a  little  milk ;  distension  in  the  epigas- 
tric zone  after  eating  but  little ;  it  impedes  respiration  ; 
nausea,  vomiting  and  hiccough  after  eating ;  sour  taste  and 
eructations,  and  rising  of  sour  liquid  in  the  mouth  after 
eating.  Aching  and  pressing  in  the  epigastrium.  It  extends 
from  the  epigastrium  up  to  the  pharynx,  and  feels  as  if  a 
ball  were  rising  to  the  throat.  Other  parts  of  the  organism 
are  affected  at  the  same  time.  After  eating,  provers  men- 
tion aching  in  the  back  of  the  neck,  vertex  and  forehead, 
with  nausea  ;  a  gentle  heat  seems  to  pass  from  the  stomach 
through  the  arms  to  the  fingers,  and  then  the  hands  appear 
as  if  dead. 


CONIUM   MACULATUM.  447 

t 
In   the    right    hypochondrium  'an   aching   increased   by 

inspiration ;  in  the  left  hypochondrium,  an  aching  tension, 
extending  lower  down  in  the  abdomen,  with  a  sensation  of 
heaviness  throughout  the  abdomen. 

In  the  abdomen,  a  constrictive  pain,  with  an  involuntary 
drawing  of  the  abdomen  up  toward  the  thorax,  and  a  press- 
ing and  aching  pain.  Cutting  and  piercing  pains  in  the 
abdomen,  with  some  degree  of  sensibility  to  pressure,  are 
noted,  along  with  the  accumulation  of  flatus  in  the  intestines. 
Pains  in  the  groins  as  if  swollen. 

As  regards  the  stool,  we  find  under  Conium  frequent  desire 
for  an  evacuation,  with  scanty  discharge  or  none  at  all ;  also 
liquid  diarrhoeic  stool  with  colic,  discharge  of  flatus,  and 
much  mucus,  or  undigested  food,  or  even  blood.  At  night 
the  evacuations  are  involuntary.  The  stools  are  preceded 
by  cutting  in  the  abdomen  and  accompanied  by  burning, 
pressing  or  cutting  pains  in  the  rectum ;  and  are  followed, 
whether  they  are  diarrhceic  or  not,  by  a  sensation  of 
general  weakness  and  trembling,  or  even  faintness. 

The  urine  is  high-colored,  and  there  is  frequent  desire  to 
pass  it,  and  the  stream  is  interrupted ;  there  is  a  spasmodic 
pressure  in  the  region  of  the  neck  of  the  bladder,  and  a 
sharp,  piercing  pain  from  without  inward  after  urinating; 
severe  cutting  pains  in  the  urethra  during  the  act  of  passing 
water.  Passing  water  does  not  relieve  the  desire  to  do  so. 
In  women,  when  passing  water,  pressure  upon  the  uterus 
and  cutting  pains. 

In  the  male  sexual  organs,  cutting  pain  through  the 
scrotum  to  the  root  of  the  penis;  pressing  and  tearing  pains 
in  the  testes;  frequent  emissions  of  semen  at  night  and 
even  during  the  day,  excited  by  the  presence  of  women ;  on 
the  other  hand,  deficient  erections  or  complete  impotence. 

In  the  female  sexual  organs,  violent  itching  of  the 
pudenda,  and  even  within  the  vagina,  day  and  night  for  a 
good  while,  most  just  after  menstruation.  The  menses 
appear  too  soon,  but  are  scanty;  they  are  preceded  by 


448  CONIUM   MACULATUM. 

dry  heat  over  the  whole  body,  anxious  dreams,  and  a 
depressed  and  anxious  state  of  mind,  and  by  piercing  pains 
in  the  region  of  the  liver ;  worse  when  lying  down  at  night, 
or  on  inspiration. 

Leucorrhoea  occurs,  of  a  white  acrid  mucus,  which 
produces  much  burning,  and  is  preceded  by  pain  in  the 
abdomen. 

In  the  respiratory  organs,  we  notice  a  catarrhal  condition ; 
abundant  discharge  of  mucus  from  the  nose,  with  hoarse- 
ness, rawness  of  the  throat  and  cough.  The  cough,  which 
is  forcible  and  frequent,  appears  to  loosen  some  mucus  in 
the  chest,  which,  however,  the  patient  cannot  expectorate 
until  some  time  has  passed,  when  a  slight  cough  brings  it  up. 
In  the  throat,  a  constant  tickling  and  itching,  provoking 
a  dry,  teasing  cough.  The  cough  becomes  worse  on  lying 
down  at  night,  and  even  threatens  to  end  in  vomiting ;  it 
produces  shocks  in  the  head  and  pain  in  the  abdomen. 
These  cough  symptoms,  especially  the  teasing,  dry  cough 
on  lying  down  at  night,  have  often  been  verified  in  practice. 

Respiration  is  short  and  labored,  especially  inspiration  ; 
pains  of  various  kinds  are  described,  as  cutting  pains  in  both 
sides  of  the  chest,  increased  by  inspiration  ;  tension  and 
weakness  in  the  chest ;  palpitation  of  the  heart,  especially 
after  drinking ;  it  is  visible  to  others  as  well  as  felt  by  the 
prover. 

The  mammae  are  hard,  very  painful  to  the  touch  (espe- 
cially during  menstruation),  with  stitching  pains,  at  night,  in 
them.  The  nipples  itch,  and  when  rubbed,  burn. 

In  the  back  are  observed,  in  the  sacral  region  and  between 
the  scapulae,  stitches  and  tensive  drawing  pains,  much 
increased  by  moving  the  arms  upward ;  severe  aching  in 
the  sacral  region  from  walking  a  short  distance,  followed  by 
nausea  and  lassitude ;  stitches  in  the  sacrum  when  standing, 
with  drawing  through  the  lumbar  vertebrae. 

In  the  extremities,  lassitude  and  weakness,  more  marked 
in  the  lower  extremities,  with  numbness  of  fingers  and  toes, 


CONIUM   MACULATUM.  449 

the  former  looking  as  if  they  were  dead.  There  are  also 
piercing  and  tearing  pains  throughout  the  extremities  and  in 
the  joints,  particularly  in  the  elbow  and  hip  joints. 

Conium  appears  to  produce  disposition  to  sleep,  in  the 
early  morning  and  by  day,  so  great  as  to  be  almost  irresist- 
ible. The  sleepiness  continues  in  the  evening,  yet  the 
prover  does  not  get  to  sleep  until  late,  and  the  sleep  during 
the  night  is  disturbed  and  interrupted,  and  attended  by  heat 
of  the  body  and  twitching  of  the  arms  and  hands,  and  much 
depression,  with  disposition  to  weep,  and  by  bad  dreams. 
As  before  remarked,  the  sleep  is  prevented  and  interrupted 
by  dry,  teasing  cough — a  symptom  which  has  received 
numberless  clinical  verifications. 

Of  fever,  no  well-marked  paroxysms  are  described.  A 
coldness,  without  thirst,  occurs  in  the  morning,  with  vertigo 
and  depression  of  spirits  ;  slight  heat  in  the  afternoon,  with 
thirst,  attended  by  relief  of  the  head  symptoms ;  sweat  in 
the  evening,  quite  abundant  during  the  first  sleep ;  or  dur- 
ing the  night ;  sweat  only  of  the  legs  ;  or,  again,  sweat  early 
in  the  morning  on  awaking,  of  the  legs,  although  they  are 
cold.  The  pulse  is  irregular,  as  regards  both  force  and 
frequency. 

Upon  the  skin,  Conium  produces  on  various  parts  of  the 
body  a  fine,  hardly  visible  eruption,  which  itches  considerably. 

Ulcers  already  existing  in  provers  assume,  under  its 
action,  a  blackish  color,  discharge  an  offensive  ichor,  and 
bleed  and  pain.  Swollen  glands  become  the  seat  of  piercing 
pains  and  soreness. 

Before  we  proceed  to  consider  the  therapeutic  applications 
of  Conium,  it  will  be  interesting  to  turn  to  Dr.  Harley's 
statement  of  its  physiological  effects,  as  observed  by  him. ] 
He  comprises  its  entire  action  in  this  brief  statement: 
"  Conium,  then,  in  a  state  of  health,  and  in  the  fullest 
medicinal  doses  that  we  can  venture  to  give,  exerts  its 
power,  chiefly,  if  not  exclusively,  upon  the  motor  centers 

1  See  previous  Article. 
30 


450  CONIUM   MACULATUM. 

within  the  cranium.  And,  of  these,  the  corpora  striata,  of 
course,  are  the  parts  chiefly  affected." 

The  peculiar  symptoms  of  the  mind  and  disposition,  the 
abnormal  acuteness  of  the  special  senses,  the  characteristic 
concomitant  symptoms  of  the  stool,  are  not  mentioned  in 
his  record ;  perhaps  because  the  doses  which  he  used  in 
proving  were  so  large  that  the  violent  symptoms  provoked 
by  them  masked  such  subjective  phenomena  as  these ;  per- 
haps, and  probably,  because  they  were  not  susceptible  of 
physiological  explanation,  and  could,  therefore,  have  no  sig- 
nificance and  no  therapeutic  value  for  him.  We,  fortunately, 
have  a  means  of  applying  to  therapeutic  uses,  symptoms  to- 
which  we  have  not  yet  found  the  physiological  key.  Our 
therapeusis,  therefore,  is  not  held  back  by  the  short-comings 
of  our  pathology,  however  greatly  it  might  be  re- enforced 
by  the  perfection  of  that  science. 

Therapeutic  Applications.  As  might  be  inferred  from  the 
symptoms,  Conium  has  been  frequently  and  successfully 
used  in  mental  affections.  Elwert  reports1  a  case  of  insanity 
which  had  for  two  years  been  unsuccessfully  treated  allo- 
pathically.  The  peculiarity  of  the  case  was  the  regular 
alternation  in  the  condition  of  the  patient.  For  ten  days  he 
would  be  depressed,  melancholy,  taciturn,  fearful,  with  rest- 
less nights ;  the  succeeding  ten  days  excited,  violent,  irri- 
table, mischievous.  Conium8,  a  dose  every  fourth  day. 
He  seemed  well  after  the  second  dose,  but  the  remedy  was 
continued,  as  a  precautionary  measure,  for  several  months, 
in  smaller  and  less  frequent  doses. 

Elwert  reports2  another  case  of  melancholy  with  enlarged 
spleen,  cured  by  Conium. 

I  have  had  occasion,  more  than  once,  to  prescribe  for  cases 
in  which,  although  there  was  evidently  uterine  disease  exist- 
ing, yet  no  characteristic  indications  for  treatment  could  be 
found  in  the  uterine  symptoms. 

lAIlgemeine  Homteopathische    Zeit-          *Allgemeine  Homceopathische  Zeit- 
ung,  ix.,  p.  196.  ung,  ix.,  p.  198. 


CONIUM    MACULATUM.  451 

The  peculiar  mental  symptoms  —  depression,  timidity, 
taciturnity,  aversion  to  society,  and  at  the  same  time  a 
dread  of  being  alone  —  induced  me  to  give  Conium,  with 
very  satisfactory  results,  as  regards  both  mental  and  uterine 
symptoms. 

In  affections  of  the  eyes,  Conium  has  been  much  and 
satisfactorily  used.  Tiilff  says,1  speaking  of  hordeola  : 
"  Conium  will  be  useful  where  the  trouble  recurs  ;  where 
several  hordeola  become  indurated,  and,  on  occasion,  inflame 
again."  He  places  Staphysagria  beside  Conium  in  this 
regard.  Its  chief  application,  however,  has  been  in  scrof- 
ulous ophthalmia. 

Knorre  says:2  "Photophobia  is  either  a  symptom  of 
inflammation  of  the  eye,  or  an  independent,  purely  nervous 
condition  of  the  eye,  without  participation  of  the  vascular 
system.  In  the  latter  case  the  photophobia  is  often  con- 
joined with  spasmodic  closure  of  the  lids.  When  it  is 
impossible  to  open  the  lids,  the  inflammation  of  the  lids  is 
generally  an  index  of  inflammation  existing  within  the  eye. 
Usually,  the  scrofulous  photophobia  is  conjoined  with  a  pale 
reddish  discoloration  of  the  globe  of  the  eye,  which  appears 
like  a  projecting  seam  around  the  cornea,  or  else  there  are 
visible  only  a  few  scattered  blood-vessels  in  the  conjunctiva. 
It  is  wonderful  how  quickly  and  certainly  Conium  relieves 
such  cases  ;  but  where  the  inflammation  predominates  and 
the  photophobia  is  not  so  marked,  Conium  is  not  so  effica- 
cious. 

Knorre,  Frank,  Segin,  Marschall  and  Thorer  publish  in  the 
Allgemeine  Homoeopathische  Zeitung,  and  in  Hygea  and  Prakt- 
ische  Beitrdge,  cases  illustrating  the  action  of  Conium  in 
strumous  ophthalmia.  In  all  of  these  cases,  the  photophobia 
was  the  prominent  symptom.  In  most  of  them,  the  flow  of  tears 
.was  excessive  and  the  liquid  acrid,  producing  much  inflam- 
mation of  the  lids;  ulcers  and  obscuration  of  the  cornea 

1  Homceopathische  Vierteljahrschrift,          *  Allgemeine  Homceopathische    Zeit- 
iii.,  p.  195.  ung,  v.,  p.  88. 


I-  K  \  S  t  C 


452  CONIUM   MACULATUM. 

were  noticed  in  some  cases.  In  this  connection,  the  follow- 
ing case  may  be  of  interest : 

A  girl  of  six  years  had  been  treated  three  months  for 
"ulcer  of  the  cornea,"  by  applications  of  a  crystal  of  sulphate 
of  copper,  and  was  brought  to  me  in  the  following  condition : 
The  eyes  were  forcibly  closed  ;  the  head  bent  down  and, 
when  possible,  buried  in  a  pillow  or  in  the  mother's  dress, 
to  avoid  the  light.  On  any  attempt  to  open  the  l|ds,  a 
copious  flow  of  tears  gushed  out,  and  the  spasmodic  closure 
was  so  firm  that  I  could  not  get  a  view  of  the  globe  of  the 
eye.  If  the  lids  were  forcibly  separated,  the  eye  was  rolled 
upward  so  as  to  hide  the  cornea.  The  sclerotic  was  not 
deeply  colored;  the  conjunctiva  palpebralis  thick,  dark-red 
and  velvety.  The  edges  of  the  lids  were  thickened,  excori- 
ated and  covered  with  light  scabs.  I  had  to  accept  the 
statement  of  my  allopathic  predecessor  that  there  was  a  deep 
ulcer  on  each  cornea. 

The  general  health  was  good.  I  gave  Conium200,  a  dose 
every  night.  In  one  week  the  photophobia  had  so  far 
diminished  that  I  could  get  a  view  of  the  cornea.  A 
large  but  not  deep  ulcer  was  visible  on  the  right  cornea,  a 
smaller  one  on  the  left.  Lachrymation  much  less;  the  lids  less 
inflamed.  The  Conium  was  continued,  but  less  frequently. 
In  one  month  from  the  beginning  of  treatment,  the  photo- 
phobia had  ceased  ;  the  ulcers  were  healed,  leaving  a  pearly 
opalescence  in  the  right  cornea,  which,  from  observation  of 
other  cases,  I  think  will  disappear  within  a  year  or  two. 

Had  there  been  disorder  of  the  digestion  and  constipation, 
such  as  clearly  to  indicate  Nux  vomica  in  this  case,  I  should 
have  given  it,  and  expected,  under  its  action,  great 
amelioration  of  the  photophobia;  such  having  been  my 
experience  in  cases  of  this  kind. 

Rentsch  reports 1  two  cases  of  deafness,  in  both  of  which  the 
deafness  had  been  preceded  and  was  accompanied  by  symp- 
toms of  disorder  of  the  liver.  The  deafness  seemed  to  depend 

1  Allgemeine  Homaopathische  Zeitung,  xxxviii.,  92,  and  xxxviii.,  90. 


CONIUM   MACULATUM.  453 

on  accumulation  of  hardened  and  dark  cerumen,  which, 
being  removed,  and  Conium  administered,  the  deafness  passed 
away.  It  would  appear  that  the  deafness  depended  on  the 
accumulation  of  cerumen,  and  was  cured  by  its  removal;  but 
it  is  noteworthy  that  the  liver  symptoms  ceased  under  the 
action  of  Conium,  and  that  the  cerumen  did  not  accumulate 
again. 

Kammerer  reports  x  a  case  of  "  cancerous  ulcer  "  of  the 
lower  lip,  from  pressure  of  tobacco-pipe,  promptly  healed, 
under  the  internal  and  external  use  of  Conium  first. 

Caspari  relates2  a  similar  case — scirrhus  of  the  lower  lip 
of  two  years'  standing,  already  ulcerated.  Under  Conium 15 
the  ulcer  healed  and  the  tumor  diminished.  Six  weeks 
after  treatment  began,  however,  the  patient  had  the  tumorv 
removed  by  a  surgeon.  How  far  the  favorable  action  of 
Conium  could  have  availed  in  this  case,  we  are,  therefore, 
unable  to  know. 

In  Gastralgia,  Dr.  Werber  states3  that  he  has  found  Conium 
always  an  excellent  remedy,  where  there  was  a  tendency  to 
constipation,  the  patient  being  of  lymphatic  constitution; 
and  he  relates  a  case  cured  by  it,  speedily,  the  symptoms 
being:  painful  spasm  of  the  stomach,  a  feeling  as  if  the 
stomach  contracted,  or  of  a  heavy  burden  upon  the  stomach  ; 
she  could  not  bear  tight  clothing ;  the  pain  never  entirely 
ceased,  but  was  sometimes  moderate,  and  then  gradually 
became  very  severe  ;  tendency  to  constipation  ;  an  obstinate, 
wearisome,  spasmodic  cough,  which  aggravated  the  gastralgia, 
the  cough  increased  by  talking,  running,  and  by  emotion. 

Dr.  Gauwerky  reports  a  cure  of  cancer  in  the  stomach, 
and  Dr.  Stens  of  cancer  on  the  lip,  with  Conium ;  the  details 
not  given.4 

Drs.  Biirkner  and  Heil  report5   cases  of  cancer  of  the 

1  A rchiv,  viii.,  part  2,  p.  70.  *  Allgemeine  Homaopathische  Zeit- 

*  Archiv,  iv.,  part  2,  p.  24.  ung,  xliv.,  p.  7°- 

3  Hygea,  vi.,  p.  321.  6  HirschePs  Zeitschrift,  iv.,  pp.  67, 

58,  I30- 


454  CONIUM    MACULATUM. 

stomach  and  perforating  ulcer  of  the  stomach  respectively, 
in  which  the  diagnosis  can  hardly  be  questioned,  and  which 
were  ultimately  fatal.  Conium,  however,  caused  such 
marked  improvement  in  both  cases,  that  we  may  suppose 
they  might  have  been  cured,  had  they  come  under  treatment 
earlier. 

Dr.  Battmann  reports1  a  case  of  enlargement  of  the 
mesenteric  glands,  ending  in  suppuration  and  a  large  abscess, 
which  was  opened  near  the  umbilicus.  The  patient  was 
terribly  reduced,  the  abscess  continued  to  discharge  and  the 
tumor  to  grow  until  Conium  was  administered,  when 
improvement  set  in  and  the  boy  rapidly  recovered. 

In  enfeebled  conditions  of  the  male  sexual  organs,  whether 
these  result  from  self-abuse  or  from  excessive  venery, 
Conium  has  proved  a  valuable  remedy.  Lobethal,  Ehrhardt, 
Marschall,  Hartmann,  bear  witness  to  its  value. 

I  have  used  it  successfully  where,  along  with  weakness, 
there  also  was  much  sexual  erethism,  amatory  thoughts 
occurring  and  even  emissions  being  provoked  by  the  mere 
presence  of  women,  to  the  great  annoyance  of  the  patient. 
In  this  regard,  Conium  belongs  to  the  same  group  as  Sepia, 
Selenium,  and  Gelseminum. 

Hahnemann 2  suggests  that  Conium  would  be  an  efficient 
remedy  in  that  kind  of  hypochondriasis  which  befalls 
unmarried  men  of  chaste  habits.  It  is  singular  that  Dr. 
Harley  should  have  been  led  to  hold  similar  views.  (Or  is  it 
not?) 

Griesselich 3  says  that  Conium  relieves  delayed  and  scanty 
menstruation,  accompanied  by  symptoms  which  point  to 
congestions  in  other  organs,  and  especially  when  the 
mammae  are  lax  and  shrunken. 

Hartmann  says:4  "Conium  is  an  excellent  remedy  when 
menstruation  fails  to  appear,  but  instead  thereof,  every  four 

1  Allgemeine  Homceopathische  Zeit-          3  ffygea,  xxi.,  p.  195. 
ung,  liv.,  p.  163.  *  Therapie,  ii.,  p.  610. 

*  Materia  Medico.  Pur  a,  iv.,  p.  238. 


CONIUM   MACULATUM.  455 

weeks,  th'ere  is  great  sensitiveness  of  the  outer  and  inner 
pudenda;  constant  dry  heat  of  the  body,  without  thirst; 
with  anxious  dreams  and  heaviness  in  all  the  limbs ;  disposi- 
tion to  weep  ;  res'tlessness  ;  anxious  care  about  every  trifle  ; 
and  piercing  pain  in  the  region  of  the  liver,  often  lasting 
several  days,  and  much  enfeebling  the  whole  body."  I 
would  add  to  the  above,  tenderness  of  the  mammae. 

Hartmann  likewise  says :  "  In  the  hysterical  attacks  and 
spasms  no  remedy  is  more  suitable  than  Conium  often  is. 
Most  of  the  symptoms  in  these  cases  originate  in  the  sexual 
system.  The  patients  often  complain  of  itching  in  and 
about  the  pudenda,  with  pain  like  the  downward  pressure 
of  the  uterus,  and  stitches  in  the  vagina ;  menses  suppressed 
or  deficient;  leucorrhoea  acrid,  with  frequent  constricting 
pains  in  the  abdomen ;  pressure  in  the  oesophagus,  as  if  a 
ball  were  rising  from  the  stomach  to  the  pharynx ;  depres- 
sion ;  discontent ;  disposition  to  weep  when  alone.  Palpita- 
tion and  pain  with  every  pulsation,  as  if  a  knife  were  thrust 
through  the  occiput,  with  irregular  pulse. 

Clinical  experience  has  shown  the  power  of  Conium 
to  arrest  the  growth  of  fibrous  tumors  of  the  uterus,  as  I 
have  had  several  occasions  to  observe.  The  indications 
must,  in  such  cases,  be  derived  from  the  concomitant 
symptoms.  One  which  I  have  several  times  observed,  and 
which  has  led  me  to  the  successful  use  of  Conium,  is  this : 
"Symptom  441,  after  every  stool,  trembling  weakness." 

Tumors  of  a  suspicious  nature  in  the  mammae  have  been 
caused  to  disappear  by  the  use  of  Conium.  They  are 
generally  the  seat  of  piercing  pains,  much  worse  at  night. 
The  rest  of  the  gland  is  abnormally  tender.  I  have  had 
several  such  cases. 

Hartung  reports l  a  "  tumor  of  the  right  mamma,  of  a 
stony  hardness,  irregular  surface,  the  seat  of  stitching  pains ; 
upon  it  a  raw,  irregular,  moist  elevation ;  swelling  of  the 
axillary  glands.  All  disappearing  under  Conium. 

1  Hygea,  xxiii.,  135,  from  Fragmenta  der  hinterlassenen  Schriften. 
Hahnemanri's. 


456  CONIUM   MACULATUM. 

Caspari  reports  a  scirrhus  of  the  left  breast  following  a 
blow,  cured  by  Conium. 

In  a  case  of  mine  in  which  Conium  relieved  the  pains, 
but  did  nothing  more,  Clematis  erecta  caused  the  disappear- 
ance of  the  tumor. 

The  action  of  Conium  in  curing  spasmodic,  dry  cough, 
worse  in  the  evening  and  at  night,  and  greatly  fatiguing  the 
patient,  is  witnessed  by  many  writers.  Hartmann,1  Kase- 
mann,2  Hirsch,3  Mayrhofer,4  Hartmann.5  I  have,  myself, 
very  often  observed  its  happy  action  in  such  coughs.  Like- 
wise, in  whooping-cough,  it  has  been  frequently  used  with 
good  effect;  chiefly,  I  think,  however,  when,  upon  the 
spasmodic  affection  a  sub-acute  bronchitis  had  supervened, 
attended  by  a  cough  of  the  above  character. 

Hirschel  relates6  that  a  tuberculous  youth  had,  for  a  long 
time,  a  tickling  cough,  dry,  provoked  by  a  spasmodic  tick- 
ling in  the  larynx,  which  was  not  tender  on  pressure.  The 
cough  came  on  about  six  P.  M.,  continued  several  hours,  and 
was  very  wearisome.  Conium2,  one  dose,  cured  the  cough. 

Schwenke  reports7  a  singular  case.  In  a  lad  of  thirteen 
years,  a  noise,  apparently  from  the  larynx,  like  tha — h, 
tha — h,  was  heard,  with  respiration  so  loud  and  disturbing 
that  he  was  dismissed  from  school.  The  muscles  of  the 
right  side  of  the  face  were  subject  to  spasmodic  twitchings, 
which  preceded  an  increase  of  the  noise.  He  also  com- 
plained of  spasmodic  pressure  in  the  region  of  the  glottis ; 
swelling  of  the  glands.  Conium6  effected  a  permanent  cure. 

Cures  of  eczema  are  reported  by  Hartlaub,  Seidel  and 
Schron. 

Enlargement  and  induration  of  the  glands,  in  whatever 
locality,  find  in  Conium,  according  to  Hartmann,  their  most 

1  Therapie,  i.,  115.  5  Allgemeine    Homocpathische  Zeit- 

*  Hygea,  x.,  359.  ung,  ii.,  109. 

3  Allgemeine  Homaopathischc  Zeit-          6  Zeitschrift,  i.,  77. 

ung,  iv. ,  308.  7  Allgemeine  Homceopathischc   Zeit- 

4  Hygea,  xviii.,495.  ung,  lx.,  152. 


CONIUM   MACULATUM.  457 

frequently  efficient  remedy ;  a  statement  confirmed  by  much 
clinical  testimony. 

These  citations  might  be  widely  extended.  What  has 
been  said  will  suffice,  however,  to  show  the  application  of 
Conium,  according  to  the  Homoeopathic  law,  and  will 
suggest  an  interesting  comparison  with  Dr.  Harley's  paper. 


REMARKS  ON  MEZEREUM. 


The  late  Dr.  Wahle,  of  Rome,  one  of  the  most  distin- 
guished, of  Hahnemann's  own  pupils,  and  well  known  by  his 
acquirements  in  the  science  of  Materia  Medica,  considered 
the  proving  of  Mezereum,  which  was  first  published  in  the 
fourth  volume  of  the  Archiv,  to  be  both  erroneous  and 
defective. 

It  is  no  very  uncommon  thing  to  find  a  Homoeopath  who 
considers  a  portion  or  the  whole  of  our  Materia  Medica 
defective.  But  the  peculiarity  which  distinguished  Wahle 
was  this :  whenever  he  saw  an  error  or  a  defect,  he  thought 
it  his  duty  rather  to  go  to  work  and  correct  the  error  or 
supply  the  defect,  than  simply  to  expose  them  and  denounce 
the  Materia  Medica,  taking  credit  meanwhile  for  his  own 
acuteness.  Accordingly,  he  instituted  a  new  proving  of 
Mezereum,  of  which  a  number  of  the  symptoms  are  here 
given.  They  were  given  me  by  his  son,  the  present  Dr. 
Wahle,  from  whom  we  may  expect  a  volume  of  his  father's 
provings  when  peace  and  liberty  shall  prevail  in  the  Papal 
States  ! 

Scalp  and  Face. 

1.  The  head  is  covered  with  a  thick,  leather-like  crust, 
under  which  thick  and  white  pus  collects  here  and  there, 
and  the  hair  is  glued  together. 

2.  OD  the  head,  great,  elevated  white  scabs,  under  which 
ichor  collects  in  quantity,  and  which  begins  to  be  offensive 
and  to  breed  vermin. 

3.  The  scabs  on  the  head  look  chalky,  and  extend  to  the 
eyebrows  and  to  the  nape  of  the  neck. 


REMARKS   ON   MEZEREUM.  459 

4.  Gray,  earthy  complexion. 

5.  The  child  scratches  the  face    continually;  it  becomes 
covered  with  blood.     The  face  and   forehead    are  red  and 
hot,  with  great  restlessness  and  peevishness.     In  the  night 
the  child  scratches  its  face  so  that  the  bed  is  covered  with 
blood  in  the  morning;  and  the  face  is  covered  with  a  scab 
which  the  child  keeps  constantly  tearing  off  anew,  and  on 
the  spots  thus  left,  raw,  large,  "  fat "  pustules  form. 

6.  The  ichor  from  the  scratched   place  excoriates  other 
parts. 

7.  The  skin  of  the  face  is  of  a  deep  inflammatory  redness, 
and  the  eruption  is  "  fat "  and  moist.     (Impetigo.) 

8.  A  honey-like  scab  around  the  mouth. 

Kidney. 

9.  Sticking  in  the  kidney  and  pain  as  if  torn. 

Menses. 

10.  Menses  too  frequent,  and  lasting  too  long. 

Larynx. 

1 1 .  In  the  larynx  a  tickling  as  if  with  a  feather,  which 
causes  coughing.     When   he   has  eaten  anything  he  must 
cough  until  he  vomits  it  up  again.     The  vomited  matter  is 
sour  or  bitter. 

12.  Cough,  with  retching  and  scratching,  or  scraping  in 
the  pit  of  the  throat,  as  if  something  sweet  lay  there  which 
cannot  be  coughed  up. 

13.  Between  six  and  seven  A.  M.  moderate  cough — at  no 
other  time. 

14.  Dry  cough  day  and  night,  with  emaciation  and  loss 
of  strength,  with  tensive  pains  across  the  thorax. 

15.  Sticking  in  the  right  side  of  the  thorax. 

(Note  by  Dr.  Wahle.     Mezereum  cures  no  small  propor- 
tion of  cases  of  whooping-cough.) 


460  REMARKS   ON   MEZEREUM. 

Inferior  Extremities. 

1 6.  Between  the  Glutaei,  four  large  scabs  surrounded  by 
dark  redness  and  on  hardened  bases. 

17.  Itching  in  the  hollow  of  the  right  knee. 

1 8.  Pains  in  the  periosteum  of  the  long  bones,  especially 
the  tibiae,  worse  at  night  and  in  bed ;  at  this  time  the  least 
touch  is  intolerable. 

19.  The  whole  shin  is  covered  with  elevated  white  scabs. 

General. 

20.  Itching  and  burning  in  the  arms  and  legs,  and,  on 
scratching,  violent  stickings  as  with  needles. 

21.  The  fiery  red  inflammation  of  the  knuckles  of  the  left 
foot  extends  over  the  instep  and  calf,  and  hard  tubercles 
form  in  the  cellular  tissue,  which  itch  on  the  slightest  touch, 
and  violent  burning  pains  ensue. 

Skin. 

22.  Blotches  break  out  over  the  whole  body. 

23.  Eruption — pale  red,   itching   after   scratching.     The 
scabs  are  adherent  and  depressed  in  the  center. 

24.  Ulcers,    covered  with    thick,   whitish,    yellow   scabs, 
under  which  thick  yellow  pus  collects. 

25.  Throbbing   around   the   ulcer,    and,    encircling   it,  a 
bright  red  areola  with  burning  pain. 

26.  In  the  ulcers,  burning  pain  in  the  evening  in  bed. 

27.  Around  the  ulcers,  fiery  red   areolae,  shining  like  a 
mirror. 

28.  Vesicles  appear  around  the  ulcers,  itching  violently 
and  burning  like  fire.     After  eight  days  these  vesicles  dry 
up,  leaving  scabs,  the  tearing  off  of  which  causes  great  pain 
and  retards  the  healing. 

29.  The    parts    affected   feel,    on   being   touched,    as    if 
swollen,  which  is  not  the  case. 

30.  Linen  or  charpie  sticks  to  the  ulcers ;  when  it  is  torn 
away  they  bleed. 


REMARKS  ON   MEZEREUM.  461 

These  symptoms  suggest  at  once  the  applicability  of 
Mezereum  to  Crusta  lactea,  to  various  forms  of  pure  Impeti- 
go, and  to  some  of  those  mercurial  or  mercuric-syphilitic 
ulcers  on  the  lower  extremities  which  often  prove  so  difficult 
to  cure.  I  have  frequently  had  occasion  to  witness  the 
prompt  curative  action  of  Mezereum  in  these  affections,  in 
which  I  have  generally  used  the  two  hundredth  potency. 
This  has  proved  efficacious  in  cases  in  which  the  lower 
dilutions  have  been  inert. 

The  characteristics  of  the  Mezereum  skin-diseases  are 
well  defined  in  the  above  symptoms,  viz. : 

Itching  occurring  in  the  evening  when  in  bed,  aggravated 
and  changed  to  burning  by  touch  or  by  scratching.  Sensi- 
tiveness to  touch. 

Ulcers  with  an  areola,  sensitive  and  easily  bleeding,  pain- 
ful at  night;  the  pus  tends  to  form  an  adherent  scab,  under 
which  a  quantity  of  pus  collects.  A  close  relationship  is 
shown  by  these  symptoms  to  exist  between  Mezereum  and 
Arsenicum,  Asafostida  and  Mercurius. 


DEAFNESS  CURED  BY  MEZEREUM. 


G.  W.  W.,  aged  seventeen  years,  small,  but  well  pro- 
portioned and  of  good  constitution,  healthy  since  his  ninth 
year,  has  been  deaf  since  he  was  four  years  old.  When 
three  years  of  age,  he  had  an  eruptive  disease  of  the  whole 
scalp,  which,  after  resisting  for  a  year  all  the  milder 
methods  of  allopathic  treatment,  was  finally  caused  to  disap- 
pear, in  the  following  manner :  A  tar-cap  was  placed  upon 
the  head,  and  when  firmly  adherent  to  the  scabs,  was  violently 
torn  off.  The  scabs  came  with  it,  leaving  the  whole  scalp 
raw.  This  raw  surface  was  moistened  with  a  saturated 
solution  of  nitrate  of  silver.  The  eruption  did  not  re- 
appear ;  but  from  that  time  the  child  was  deaf. 

"The  condition  of  the  youth  now  excites  the  earnest 
solicitude  of  his  friends.  His  inability  to  move  in  society, 
or  to  get  a  situation  in  business,  on  account  of  his  deafness, 
has  produced  a  morbid  state  of  mind.  He  broods  over  his 
infirmity,  and  secludes  himself  even  from  his  own  family." 

Under  these  circumstances,  he  applied  to  me  to  be  cured 
of  his  deafness.  His  present  condition  is  as  follows :  He 
is  quite  unable  to  hear  ordinary  conversation,  and  has  never 
heard  a  sermon  in  his  life.  A  loud-ticking  lever  watch  can 
be  heard  at  a  distance  of  three  and  a  half  inches  from  either 
ear.  On  application  of  the  watch  to  his  forehead,  or  to  the 
teeth,  he  hears  it  distinctly.  Occasional  buzzing  noises  in  front 
of  the  ears.  A  physical  examination  of  his  ears  reveals  the 
following  condition  :  The  external  meatus  is  abundantly  sup- 
plied with  soft,  normal  wax.  The  membrana  tympani  is  white, 
opaque,  and  evidently  thickened.  When  the  patient  attempts 
to  inflate  the  middle  ear  (which  he  accomplishes,  with  great 


DEAFNESS  CURED  BY  MEZEREUM.        463 

difficulty,  by  closing  both  mouth  and  nose  and  making  a 
forcible  expiration),  the  membrana  tympani  becomes  but 
very  slightly  convex,  and  it  is  impossible  to  distinguish 
its  distended  blood-vessels.  There  has  evidently  been  a 
deposit  in  the  substance  of  the  membrane.  On  examination 
of  the  throat,  it  appears  that  the  orifice  of  the  eustachian 
tube  is  free. 

Feb.  3,  1857.  Patient  received  a  powder  containing 
three  globules  of  Mezereum30,  to  be  taken  on  retiring. 

Feb.  24.  Thinks  he  hears  better — "every  sound  seems 
much  louder  than  before."  Hears  my  watch  at  a  distance  of 
four  and  a  half  inches  from  the  right  ear,  and  four  and  a 
quarter  from  the  left  ear.  Saccharum  lactis. 

March  i.  Has  not  improved  during  the  last  week.  Meze- 
reum30, three  globules. 

March  27.  Hears  my  watch,  with  the  right  ear,  six  and 
a  half  inches,  and  with  the  left  ear,  seven  inches.  Saccha- 
rum lactis. 

April  20.  Hears  my  watch,  with  the  right  ear,  at  a 
distance  of  ten  inches,  and  with  the  left,  at  a  distance  of 
fourteen  inches.  Hears  ordinary  conversation  easily,  with 
attention.  Saccharum  lactis. 

Sept.  28.  Has  been  steadily  improving  until  three  weeks 
ago,  when  he  became  more  deaf  again,  without  apparent 
cause.  Mezereum30,  three  globules,  on  retiring. 

Jan.  26,  1858.  Hears  my  watch  at  a  distance  of  fourteen 
inches  from  the  right  ear,  and  twenty-four  inches  from 
the  left  ear.  Deafness  returns  when  he  takes  cold,  but 
disappears  with  the  cold.  Mezereum30,  three  globules,  on 
retiring. 

March  19.  To  his  surprise,  on  going  to  church,  although 
seated  at  the  extreme  end  of  a  very  large  building,  he  dis- 
tinctly heard  the  whole  sermon — for  the  first  time  in  his  life. 
On  physical  examination,  the  opacity  of  the  membrana  tym- 
pani is  found  to  have  disappeared,  and  its  elasticity  to  have 
sensibly  increased. 


464         DEAFNESS  CURED  BY  MEZEREUM. 

May  24.  Patient  writes  me  that  he  has  obtained,  with- 
out difficulty,  a  situation  in  a  store,  and  that  he  is  no  longer 
conscious  of  being  deaf.  His  sole  difficulty  is  that,  as  he  has 
the  reputation  of  being  deaf,  everybody  shouts  at  him. 
His  father  writes,  that  the  son's  hearing  is  "  perfectly 
restored." 

REMARKS.  The  success  of  the  treatment  resorted  to  in 
this  case  warrants  a  few  remarks  upon  its  rationale.  Here 
was  a  case  which  presented  to  the  practitioner  apparently 
nothing  on  which  to  base  a  prescription.  There  was  a  thick- 
ened membrana  tympani  —  nothing  more.  The  work  of 
thickening  had  probably  been  accomplished  years  ago.  Here 
was  a  pathologico-anatomical  condition,  but  no  pathological 
process  and,  consequently,  there  were  no  abnormally  per- 
formed functions — or,  in  other  words,  no  symptoms  of 
disease — from  which  to  draw  indications  for  the  treatment. 
The  pathologico-anatomical  condition  threw  no  certain  light 
on  the  pathological  process  which  had  produced  it — just  as 
a  knowledge  of  the  town,  at  which  a  traveler  has  arrived, 
gives  no  certain  clue  to  the  road  by  which  he  reached  it. 

But,  as  Hahnemann  advised  his  disciples,  the  history  of  a 
case  is  often  of  the  utmost  importance  in  determining  the 
treatment.  In  the  case  before  us  the  coincidence  between 
the  violent  removal  of  the  tinea  capitis  by  nitrate  of  silver, 
and  the  appearance  of  the  deafness,  was  too  marked  to 
escape  notice.  It  could  not  fail  to  occur  to  the  practitioner 
that  the  scalp  disease  was  one  phase  of  a  psoric  affection,  as 
Hahnemann  would  have  called  it,  or  of  a  dyscrasia,  as  the 
modern  school  of  German  pathologists  would  say  (for  the 
doctrine  of  the  dyscrasias  is  but  a  rehash  of  Hahnemann's 
psora  theory),  and  that  this  affection,  disturbed  in  its  locali- 
zation upon  the  scalp,  had  transferred  itself  to  the  tissues  of 
the  ear.  It  further  occurred  to  me  that,  since  in  this  latter 
localization  there  were  no  sufficient  indications  for  a  pre- 
scription, I  might  find  such  indications  in  the  phenomena  of 


DEAFNESS  CURED  BY  MEZEREUM.        465 

the  former  localization  upon  the  scalp.  I  accordingly 
addressed  myself  to  the  task  of  getting  a  complete  picture 
of  this  affection,  which  had  disappeared  thirteen  years  before. 
By  good  fortune,  the  mother  of  the  patient  was  possessed 
of  a  good  memory,  and  of  very  excellent  powers  of  descrip- 
tion, and  from  her  I  learned  that  "  thick,  whitish  scabs,  hard 
and  almost  horny,  covered  the  whole  scalp.  There  were 
fissures  in  the  scales,  through  which,  on  pressure,  there 
exuded  a  thick,  yellowish  pus,  often  very  offensive.  There 
was  great  itching,  and  a  disposition  to  tear  off  the  scabs 
with  the  finger-nails — especially  troublesome  at  night" 

The  remedy  which  corresponds  most  closely,  in  its  patho- 
genesis,  with  the  above  group  of  symptoms,  is  undoubtedly 
Mezereum.  In  the  introduction  to  the  proving  of  that  drug, 
in  the  Chronic  Diseases,  vol.  iv.,  Hahnemann  recommends 
it  for  moist  eruptions  of  the  scalp.  In  the  proving,  in  the 
Archiv,  vol.  iv.,  many  symptoms  point  to  a  similar  erup- 
tion—  itching,  especially,  at  night;  but  the  conclusive  group 
of  pathogenetic  symptoms  is  the  following,  from  a  new 
proving  of  Mezereum,  by  the  late  Dr.  Wahle,  of  Rome,  of 
which  the  manuscript  was  shown  me  by  his  son,  the  present 
Dr.  Wahle : 

"  Head  covered  over  with  a  thick  leather-like  crust,  under 
which  thick  white  pus  collects  here  and  there,  and  the  hair 
is  glued  together;  on  the  head,  great,  elevated,  irregular, 
white  scabs,  under  which  pus  collects  in  quantity,  and 
becomes  offensive  and  breeds  vermin.  The  child  keeps 
scratching  its  face  and  head  at  night,  and  continually  tears 
off  the  scabs." 

The  resemblance  between  these  groups  of  symptoms  was 
so  striking  that  Mezereum  was  at  once  selected  as  the 
remedy  for  this  case  of  deafness,  just  as  if  the  scalp  affection 
had  been  still  in  its  original, form,  and  had  been  the  imme- 
diate object  of  the  prescription. 

It  not  unfrequently  occurs  that  we  are  called  upon  to 
prescribe  for  what  seem  rather  results,  of  morbid  actions, 
31 


466         DEAFNESS  CURED  BY  MEZEREUM. 

than  active  diseases.  In  such  cases  it  would  seem  that  we 
may  often  successfully  base  a  prescription  upon  the  symp- 
toms of  a  diseased  condition  which  no  longer  exists,  but 
which  form  in  reality  a  part  of  the  case.  It  may  not  be 
amiss  to  call  attention  to  the  completeness  of  the  corrobora- 
tion  which  this  case  affords  (were  any  needed)  of  Hahne- 
mann's  psora  theory.  It  is  hardly  necessary  to  say  that 
Hahnemann  had  no  idea  of  restricting  the  appellation  psora 
to  itch,  as  we  understand  that  term,  that  is  to  the  disease 
caused  by  the  acarus.  On  the  contrary,  in  his  Chronic 
Diseases,  vol.  iv.,  he  expressly  includes  under  it  various 
forms,  as  "Itch,  Tinea  Capitis,  Herpes,  etc." 


CROUP   CURED   BY  BCENNINGHAUSEN'S 
POWDERS. 


On  the  evening  of  January  24th,  I  received  a  message  to 
the  effect  that  a  little  boy,  aged  eighteen  months,  fat  and 
healthy,  was  slightly  feverish,  and  somewhat  hoarse.  I  was 
requested  to  send  some  medicine.  I  sent  a  powder  of 
Aconite12,  mentioning  to  the  messenger  that  croup  might 
perhaps  be  threatening,  and  requesting  to  be  sent  for  on  the 
first  indications  of  that  disease.  The  next  morning  I  was 
told  that  the  child  was  not  much  better,  and  was  requested 
to  visit  it  in  the  course  of  the  day.  I  went  immediately. 
As  soon  as  the  hall-door  was  opened,  I  heard  the  hoarse 
ringing  respiration  of  the  child,  which  was  in  the  second 
story,  and  which  I  found  sitting  up  in  its  crib,  with  an 
expression  of  great  anguish,  breathing  at  the  rate  of  35  in 
the  minute  and  with  great  labor.  There  was  but  little  cough; 
occasionally,  an  effort  which  resulted  in  a  hoarse  dry  bark, 
but  which  was  immediately  suppressed,  apparently  because 
it  interfered  with  respiration.  The  face  was  turgid  and  of  a 
purple  hue.  The  hands  were  frequently  applied  convul- 
sively to  the  larynx,  but  as  a  general  thing  the  child  was 
quiet,  looking  with  pitiful  appealing  eyes  to  the  by-stander  as 
if  for  aid.  The  skin  was  hot  and  dry  except  on  the  fore- 
head, which  was  moist  and  cool,  pulse  hard,  not  full,  130. 
On  saying  to  the  mother,  "  The  child  is  exceedingly  ill,"  I 
was  told,  "  He  has  been  as  bad  if  not  worse  all  night."  He 
had  vomited  once,  about  an  hour  before  my  arrival,  bring- 
ing up  a  small  piece  of  tough  membrane. 

Here  was  a  case  of  membranous  croup  of  great  severity, 
which  had  been  in  full  blast  at  least  twelve  hours  before  I 


468  CROUP   CURED 

was  called  to  it ;  in  which  the  purple  turgid  face  and  the 
exhausted  aspect  of  the  child  showed  that  the  powers  of 
life  had  already  begun  to  fail  under  the  imperfect  decarboni- 
zation  of  the  blood.  Considering  the  gravity  of  the  case, 
and  its  long  duration  before  treatment  was  begun,  I  hesitated 
to  give  the  powders  recommended  by  Bcenninghausen,  but 
gave  at  once  Bromine,  first  centesimal,  in  water,  a  tea- 
spoonful  of  the  solution  every  fifteen  minutes. 

At  the  end  of  two  hours  the  child  was  in  no  respect 
better;  the  pulse  was  weaker  and  more  frequent;  there  had 
been  no  relief  for  an  instant  to  the  labored  character  of  the 
respiration,  which  numbered  now  40  in  the  minute.  I  gave 
Hepar  sulphuris,  second  trituration,  alternately  with  the 
Bromine.  At  the.  end  of  two  hours  there  was  still  no  change 
for  the  better ;  the  disease  was  steadily  advancing,  as  it 
seemed,  to  a  fatal  termination.  Already  it  had  reached  a 
point  at  which  I  have  seen  both  Guersant  and  Trousseau  at 
the  Enfans  Malades  refuse  to  perform  tracheotomy,  on  the 
ground  that  the  disease  had,  by  its  long  duration,  so  pre- 
vented oxygenation  of  the  blood  and  consequent  renovation 
of  tissues  that  a  favorable  issue  could  not  be  hoped  for. 
I  determined  now  to  give  the  Bcenninghausen  powders ; 
waiting  therefore  a  half  hour  from  the  time  at  which  the  last 
dose  of  the  Hepar  was  given,  I  gave  a  powder  of  Aconite200, 
to  be  followed  at  intervals  of  a  half  hour  by  Hepar  20°, 
Spongia200,  and  this  series  repeated  (the  method  indicated 
in  a  foot-note  to  my  translation  of  Boenninghausen's  article).1 
It  was  now  5  P.  M.,  a  time  of  day  after  which  croup  gen- 
erally begins  to  be  aggravated.  At  7  o'clock  the  child  was 
greatly  relieved,  respiration  30  in  the  minute,  much  less 
labored,  the  sound  softer,  cough  rather  more  frequent  and 
somewhat  loose  in  sound.  I  left  a  second  series  of  the  pow- 
ders to  be  taken  at  intervals  of  one  hour.  The  child  slept  at 
ii  P.  M.,  and  at  intervals  during  the  night,  and  the  next 
morning  was  so  much  better  that  it  seemed  unnecessary 

1  American  Homoeopathic  Review,  vol.  ii.,  p.  212. 


BY  BCENNINGHAUSEN'S  POWDERS.  469 

to  give  more  medicine,  although  I  left  a  series  of  the  pow- 
ders to  be  given  in  case  of  a  relapse.  They  were  not  given, 
however.  The  child  recovered  rapidly  without  relapse  or 
sequelae  of  any  kind,  and  on  the  fifth  day  was  as  well  as 
usual. 

This  was  unquestionably  the  most  severe  case  of  croup 
that  I  have  ever  seen  recover  in  this  or  any  country. 
Judging  from  my  experience  with  Bromine  and  Hepar  in 
other  cases,  I  have  no  hesitation  in  saying  that,  not  acting 
more  evidently  and  more  promptly  than  they  appeared  to  do 
in  this  case,  nothing  whatever  was  to  be  hoped  for  from  them. 
In  croup,  if  they  act  beneficially  at  all,  they  do  so  promptly. 
It  seems  impossible,  therefore,  to  ascribe  the  recovery  of  this 
child  in  any  degree  to  these  remedies  or  tq^deny  the  curative 
action  of  the  Bcenninghausen  powders. 


CHRONIC   DIARRHCEA    CURED   BY  A   SINGLE 
DOSE  OF  A  HIGH  POTENCY. 

Charles  C ,  aged  ten  years,  has  had  diarrhoea  ever 

since  he  was  four  years  old ;  has  been  subjected  to  various 
modes  of  treatment,  including  the  Homoeopathic,  but  with- 
out any  material  benefit.  He  is  of  good  height  for  his  age, 
but  is  emaciated  to  an  extraordinary  degree ;  —  not  only  are 
his  tissues  utterly  devoid  of  fat,  but  the  muscles  are  wonder- 
fully attenuated^- — my  thumb  and  finger  meet  with  ease 
around  the  middle  of  his  arm.  Nevertheless,  he  is  active 
and  full  of  fun.  His  appetite  is  prodigious ;  thirst  very 
great ;  he  complains  of  distress  in  the  epigastric  region, 
which  is  much  greater  just  before  a  stool,  compelling  him  to 
press  his  hand  upon  that  region  and  bend  forward ;  this  is 
relieved  to  some  extent  by  a  movement  of  the  bowels.  The 
epigastrium  is  sensitive  when  touched.  The  abdomen  is 
greatly  distended ;  this  is  habitual ;  it  is  hard  and  tympa- 
nitic;  by  forcible  manipulation,  one  can  detect  hard  ovoid 
bodies,  deep  in  the  abdomen,  as  large  as  a  pigeon's  egg. 
The  number  of  stools  in  twenty-four  hours  varies  from  five 
to  twenty.  They  are  copious,  pappy,  of  a  dark  greenish- 
brown  color,  quite  offensive.  They  occur  chiefly  during  a 
period  from  4  A.  M.  to  noon — seldom  after  noon  or  before 
midnight.  Though  so  copious,  they  do  not  produce  faint- 
ness  or  a  sense  of  weakness,  nor  does  the  boy  complain  of 
debility,  although  aware  that  he  is  not  so  strong  as  other 
boys  of  his  age.  On  the  contrary,  he  is  lively  and  full  of 
mischief,  his  chief  complaint  being  of  the  very  frequent  pain 
in  the  upper  part  of  the  abdomen,  which  he  describes  as  a 
"  grumbling  pain,"  and  sometimes,  "  a  very  sharp  squeeze." 

Of  the  particulars  of  his  previous  treatment  I  could  learn 


CHRONIC   DIARRHCEA   CURED.  4/1 

but  little.  During  the  summer  preceding  my  first  visit  to 
him  he  had  been  under  homoeopathic  treatment  (not  in  this 
village1),  and  I  was  told  that  he  had  taken  a  good  deal  of 
Arsenicum,  which,  however,  to  the  great  surprise  of  his  phy- 
sician had  done  him  no  good. 

And,  indeed,  on  a  hasty  review  of  the  symptoms,  it  might 
seem  extraordinary  that  Arsenicum  should  have  failed  to 
cure  the  case.  The  dark,  pappy,  offensive  stools,  preceded 
by  tolerably  acute  pain  in  the  abdomen,  with  great  and 
excessive  emaciation,  comprehend,  to  speak  with  the  pathol- 
ogists  of  our  school,  the  essential  features  of  this  present 
disease  of  the  alimentary  canal,  and,  moreover,  present  a 
fair  simile  to  the  Arsenicum  disease.  A  careful  examina- 
tion, however,  will  show  that  some  even  of  these  symptoms 
vary  in  important  aspects  from  the  corresponding  symptoms 
of  Arsenicum,  while  other  symptoms  which  betray  the 
diathesis  of  the  patient  are  quite  at  variance  with  those  of 
Arsenicum.  For  example,  in  the  first  place,  the  thirst, 
although  very  great,  is  not  satisfied  by  a  small  quantity  of 
water,  as  in  the  Arsenicum  disease ;  the  stool,  though 
similar  in  color,  consistency  and  odor  to  that  of  Arsenicum, 
is  copious,  that  of  Arsenicum  being,  like  all  the  secretions 
under  that  drug,  scanty.  It  is  not  attended  by  as  great  a 
sense  of  exhaustion  as  one  would  expect  to  find.  Indeed, 
the  debility  and  muscular  weakness  are  much  less  than  one 
would  suppose  must  result  from  a  diarrhoea  so  copious  and 
of  so  long  duration,  whereas  in  the  Arsenicum  disease,  the 
general  prostration  is  much  greater  than  can  be  accounted 
for  by  the  actual  drain  upon  the  system.  In  the  second 
place,  the  aggravations  occur  in  the  mornings,  while  in  the 
Arsenicum  disease  they  occur  almost  exclusively  in  the 
evenings.  The  abdomen  is  distended  and  hard,  making  the 
child  quite  pot-bellied,  whereas  Arsenicum  produces  retrac- 
tion of  the  abdominal  walls  and  concavity  of  the  abdomen. 
The  appetite  is  very  great,  a  symptom  which  is  not  charac- 
teristic of  Arsenicum. 

1  Newburgh,  N.  Y. 


472  CHRONIC   DIARRHCEA   CURED 

Then  it  appears,  although  the  symptom  to  which  my 
attention  was  first  called,  as  being  the  symptom  of  chief 
importance,  seemed  to  point  to  Arsenicum  as  its  remedy, 
yet  the  conditions  and  concomitants  of  that  symptom  and 
the  general  symptoms  of  the  patient  did  not  at  all  demand, 
but  decidedly  contra-indicated,  that  remedy. 

But  with  what  propriety  can  the  diarrhoea,  the  frequent 
liquid  stool,  be  regarded  as  the  symptom  of  chief  impor- 
tance, the  primary  symptom,  so  to  speak  ?  It  is  that  symp- 
tom which  would  first  strike  the  observation  of  the  patient's 
friends,  because  so  decidedly  objective  in  its  character ;  but 
it  is  obviously  a  secondary  phenomenon,  depending  on  the 
diseased  state  of  the  alimentary  canal  and  of  the  mesenteric 
glands ;  and  this  diseased  state  depended  unquestionably 
upon  a  general  depressed  state  of  the  vascular  and  nervous 
systems,  or  upon  a  modified  vital  action,  which  is  mani- 
fested in  those  general  symptoms,  upon  which  we  predicate 
distinctions  of  dyscrasia  and  diathesis.  Taking  this  view  of 
the  case,  it  is  evident  that  to  assign  the  chief  place  in  our 
scheme  of  symptoms  to  the  diarrhoea,  would  be  to  prescribe 
for  symptoms  (and  secondary  ones  at  that)  rather  than  for 
the  whole  morbid  state  of  the  patient.  But  if,  in  accordance 
with  the  view  I  have  indicated,  we  give  but  a  secondary 
place  to  the  diarrhoea,  it  becomes  easy  to  find  a  remedy  for 
our  case.  The  distended,  prominent  abdomen,  the  indurated 
and  enlarged  glands,  the  excessive  appetite,  the  great  thirst, 
demanding  large  draughts  of  water,  the  pain  in  the  upper  part 
of  the  abdomen  just  before  the  stool,  the  tender  epigastrium, 
the  copious  and  long-continued  diarrhoea,  without  correspond- 
ing exhaustion, — all  these  symptoms  combine  to  exhibit  a 
condition  which  finds  its  exact  simile  in  Calcarea  carbonica. 
Moreover,  although  Calcarea  does  not  produce  stools  of  the 
color  met  with  in  this  case,  yet  the  conditions  of  stool 
produced  by  Calcarea  correspond  to  those  of  the  case  in 
hand.  The  aggravations  of  Calcarea  are  frequently  in  the 
morning,  and  the  pain  in  the  abdomen  is  relieved  by  warmth 


BY   A    SINGLE   DOSE    OF   A   HIGH   POTENCY.          473 

as  in  this  case.  Calcarea  carbonica,  therefore,  was  selected 
as  the  appropriate  remedy,  and  the  propriety  of  giving  it 
being  so  obvious  that  I  could  not  suppose  it  had  been  over- 
looked by  the  physicians  who  had  previously  attended  the 
lad,  and  there  being  every  probability  that,  if  they  gave  it 
at  all,  they  gave  it  in  low  potencies,  I  concluded  to  give  the 
two  hundredth.  Two  globules  were  accordingly  dissolved 
in  four  ounces  of  water,  and  a  tea-spoonful  of  the  solution 
ordered  to  be  given  every  four  hours.  For  the  week  pre- 
ceding this  prescription  the  boy  had  had  twenty  stools  daily, 
and  very  great  pain. 

On  the  third  day  after  the  remedy  was  administered,  I 
called  again.  The  lad  had  had  but  one  stool  daily  since  the 
day  after  my  visit ;  and  during  the  ten  months  which  have 
since  elapsed,  his  bowels  have  moved  regularly,  but  once 
daily,  the  stool  being  in  all  respects  normal.  In  the  space 
of  one  month  the  lad  became  so  ruddy  and  plump — having 
gained  twenty-two  pounds  in  weight — that  I  should  not  have 
known  him.  As  he  gained  flesh  and  strength,  the  rotundity 
of  the  abdomen  disappeared,  and  at  the  end  of  the  third 
month  the  indurated  abdominal  glands  were  no  longer  to  be 
felt.  He  received  no  medicine  besides  the  single  dose  of 
Calcarea  carbonica'200,  above  mentioned. 

It  may  seem  incredible,  and  I  confess  I  cannot  explain  it, 
that  a  drain  so  long  established  and  so  copious  could  be 
instantaneously  checked  without  producing  at  least  tempo- 
rary disturbance  of  some  other  character.  The  fact,  how- 
ever, does  not  admit  of  dispute. 

In  a  review  of  this  case,  two  points  seem  worthy  of  notice. 

1.  The  prompt  and  enduring  action  of  the  high  potency. 
I   would  not  venture  to  say  that  a  low  potency  would  not 
have  acted  as  promptly  ;    certainly,  however,  nothing  better 
could  be  imagined  or  desired. 

2.  The  great  importance  of  paying  careful  regard,  in  the 
selection    of  a   remedy,   to  the  general  symptoms  of  the 
patient,   as   denoting  the   dyscrasia,   and  to  the  conditions 
(time  and  character  of  aggravation,  etc.)  of  every  symptom. 


PTERYGIUM    CRASSUM    CURED    BY    A    SINGLE 
REMEDY  IN  A  HIGH  POTENCY.1 


The  following  case  is  thought  worthy  of  special  notice  for 
several  reasons.  It  presents  an  instance  of  a  diseased  con- 
dition which,  being  on  the  surface  of  the  eye,  may  be  made 
the  subject  of  constant  observation  : 

Such  a  condition  has  never,  so  far  as  my  knowledge  goes, 
been  produced  by  any  remedy.  It  is  not  contained  in  any 
proving.  A  homoeopathic  prescription  for  it  must  therefore 
be  based  upon  the  general  characteristic  symptoms  which 
the  patient  may  present,  and  to  which  corresponding  symp- 
toms may  be  found  in  some  drug-proving. 

The  writer  had  never  treated  a  case  before,  and  does  not 
recall  any  record  of  a  cure  made  by  homoeopathic  remedies. 
He  was  not,  consequently,  influenced  in  the  selection  of  a 
remedy  by  any  knowledge  ex  usu  in  morbis. 

The  patient  was  not  encouraged  to  expect  a  cure,  but 
looked  forward  to  a  surgical  operation  as  a  matter  of  neces- 
sity. There  can  be  no  ground,  then,  for  ascribing  the  cure 
to  faith,  the  last  resort  of  the  credulous  incredulous,  to  whom 
it  is  easier  to  believe  that  a  grave  and  material  disease  can 
be  cured  by  imagination,  the  intangible,  than  by  a  high 
potency,  the  imponderable  ! 

The  cure  was  effected  by  a  single  remedy,  in  a  high 
potency,  the  two  hundredth  (prepared  by  myself). 

J.  N.  S.,  a  farmer,  aged  fifty-five  years, —  generally  in  good 
health, — has  had  for  three  years  a  pterygium  upon  each  eye. 
Starting  from  the  inner  angle  of  the  eye,  this  morbid  growth, 

1  Read  before  the  Homoeopathic  Medical  Society  of  Cayuga  County, 
N.  Y.,  June  22,  1864. 


PTERYGIUM   CRASSUM   CURED.  475 

which  was  thick,  opaque,  and  richly  supplied  with  large 
blood-vessels,  and  much  resembled  a  strong  muscle,  extended 
over  the  sclerotic,  had  invaded  the  cornea  with  a  thick,  broad 
extremity,  and  now  covered  more  than  one-half  of  the  pupil, 
rendering  the  patient  nearly  blind. 

The  conjunctiva  of  the  remaining  portion  was  deeply 
injected.  The  eyes  were  filled  in  the  morning  with  a  muco- 
purulent  secretion. 

The  patient  was  unable  to  endure  artificial  light,  and  com- 
pelled to  carefully  protect  the  eyes  during  the  day-time. 
Reading  was  out  of  the  question  at  all  times. 

Within  the  last  six  months  the  growth  of  the  pterygium 
had  been  very  rapid. 

The  eyes  were  very  painful,  especially  in  the  evening  and 
at  night.  The  pain  was  in  the  inner  angle  of  the  eye,  a 
pricking,  smarting  pain,  seeming  to  be  situated  deep  in  the 
globe.  Dust  in  the  atmosphere  greatly  aggravated  the  pain. 
In  addition  there  was  a  very  severe  pressure  at  the  root  of 
the  nose  and  across  the  supra-orbital  region.  There  was 
considerable  lachrymation,  especially  in  the  evening. 

The  effect  of  this  disease  was  to  entirely  incapacitate  the 
patient  for  every  kind  of  business. 

In  this  condition  the  patient  placed  himself  under  my  care 
about  the  1st  of  July,  1863.  He  had  been  advised  that  an 
operation  for  the  removal  of  the  pterygium  was  the  only 
thing  to  which  he  could  look  for  relief,  but  had  also  been 
told  that  in  the  present  inflamed  condition  of  the  eyes,  and 
at  the  unfavorable  season  of  midsummer,  the  operation  would 
expose  him  to  no  inconsiderable  danger  of  sequelae  that 
might  be  very  disastrous.  He  had  been  counseled  to  endure 
his  present  symptoms  until  the  weather  should  become 
colder  and  more  favorable  for  the  operation. 

His  motive,  therefore,  in  coming  to  me  was  to  get  some 
palliation  of  his  suffering,  some  temporary  relief,  that  the 
summer  months  might  be  made  more  tolerable  to  him. 

I  gave  him  no  encouragement  to  believe  that  I  could 'do 


476  PTERYGIUM   CRASSUM   CURED 

more  than  slightly  palliate  his  sufferings ;  for,  as  has  been 
already  remarked,  I  had  never  treated  a  pterygium,  and 
never  heard  of  a  homoeopathic  cure  of  one. 

Seeking  a  homoeopathic  remedy  for  the  case,  as  it  has 
been  stated,  I  could  get  no  light  from  the  objective  symp- 
toms, since  no  proving  contains  anything  like  them. 
Nothing  remained  but  the  subjective  symptoms.  Of  these 
the  pain,  smarting  and  pricking,  and  which  was  singularly 
confined  to  the  inner  angle  of  the  eye  and  seemed  deep- 
seated,  the  pushing  pain  at  the  root  of  the  nose,  the  marked 
aggravation  in  the  evening, —  these  symptoms  together  sug- 
gested Zincum  metallicum. 

In  the  proving  of  Zincum  we  find  (symptoms  194,  197, 
205,  209),  biting,  pricking  and  soreness  in  the  inner  angle 
of  the  eyes  ;  lachrymation,  especially  in  the  evening ;  inflam- 
mation and  redness  of  the  conjunctiva;  suppuration  of  the 
inner  angle  with  soreness, —  many  of  these  symptoms  being 
aggravated  in  the  evening ;  symptom  248,  "  Pressure  on 
the  root  of  the  nose,  as  if  it  would  be  pressed  into  the  head, 
almost  intolerable,"  together  with  249—25 1  of  a  like  sig- 
nificance. 

The  other  symptoms  of  the  patient  being  well  covered  by 
those  of  Zincum,  I  concluded  to  give  this  remedy. 

I  felt  the  more  hope  of  some  benefit  from  it,  from  the  fact 
that  my  (allopathic)  preceptor,  who  had  much  experience 
and  success  in  the  treatment  of  diseases  of  the  eye,  had 
often  said  that  Sulphate  of  zinc,  applied  externally,  had  a 
more  beneficial  effect  in  pterygium  than  any  other  astringent 
or  caustic  application. 

Now,  as  Sulphate  of  zinc  is  by  no  means  so  powerful  an 
astringent  or  caustic  as  many  other  substances  that  are  com- 
monly used  as  applications  in  such  cases,  certainly  the  supe- 
riority of  Zinc  could  not  be  attributable  to  its  mere  posses- 
sion of  those  properties  which  it  has  in  common  with  other 
collyria,  as,  for  example,  Nitrate  of  silver,  Sulphate  of 
copper,  etc.,  etc.  It  must  be  due,  then,  to  s"ome  specific 


BY   A   SINGLE   REMEDY   IN   A   HIGH   POTENCY.       4/7 

quality  of  the  Zinc.  In  passing,  -let  me  venture  the  remark, 
that  in  clinical  observations  like  the  above,  made  by  sagacious 
allopathic  observers,  we  may  often  find  valuable  hints  to 
supplement  our  pathogenetic  knowledge  of  drugs. 

To  return  to  the  case,  I  determined  to  give  the  two 
hundredth  potency  of  Zinc,  the  case  being,  as  it  seemed  to 
me,  a  very  fine  one  for  experiment  with  a  high  potency. 

I  gave  four  powders  of  sugar  of  milk,  each  containing 
three  globules  of  Zincum  metallicum200,  and  ten  additional 
powders  containing  nothing  but  sugar  of  milk ;  a  powder 
to  be  taken  dry  on  the  tongue,  every  night  on  retiring ;  the 
patient  to  report  on  the  fourteenth  day.  No  change  to  be 
made  in  diet,  regimen,  or  occupation.  No  external  applica- 
tions to  be  made. 

July  15.  The  patient  presented  himself  and  stated  that  on 
the  third  day  after  he  began  to  take  the  powders  he  began 
to  feel  much  better,  and  that  now  he  was  entirely  free  from 
pain  and  discomfort  and  from  lachrymation.  The  morning 
secretion  was  much  less.  I  thought  the  eye  appeared  less 
inflamed,  but  beyond  this  there  was  no  change  in  its  physi- 
cal condition.  I  gave  sugar  of  milk  and  requested  a  report 
in  a  fortnight,  or  sooner,  in  case  the  pains  should  return. 

August  I.  No  return  of  pain.  The  pterygium  has  cer- 
tainly diminished  in  size ;  it  is  not  so  thick  and  luxuriant  as 
formerly.  Sugar  of  milk. 

August  10.  The  patient  came  to  apprise  me  of  a  return 
of  the  pains  to  moderate  extent.  I  gave  three  powders  of 
Zincum  metallicum200,  to  be  taken  every  night  on  retiring. 

August  20.  The  pains  disappeared  after  the  first  powder 
and  have  not  returned.  The  pterygium  is  evidently  de- 
creasing. 

Twice  again  the  pains  returned,  and  on  each  occasion  I 
gave  a  powder  of  the  Zincum200.  By  the  end  of  October, 
the  time  fixed  for  the  operation,  the  pterygium  had  dimin- 
ished so  far  that  it  was  only  a  little  colorless  ridge  in  the 
extreme  inner  angle  of  the  eye,  the  sight  was  entirely 


4/8  PTERYGIUM   CRASSUM   CURED. 

restored,  the  patient  could  use  his  eyes  freely  both  by  day 
and  in  the  evening ;  there  was  no  longer  any  thought  of  the 
operation ;  in  fact,  it  would  have  been  hard  to  find  anything 
to  operate  upon. 

At  the  present  date  there  is  no  trace  of  the  pterygium 
remaining  upon  the  left  eye.  In  the  inner  angle  of  the 
right  eye  there  is  a  small  speck  yet  visible. 


PANAMA  FEVER  CURED  BY  ARSENICUM. 

A.  J.,  aged  thirty,  strong,  muscular  and  hitherto  healthy, 
sent  for  me.  He  had  been  exposed  about  eight  weeks 
before,  while  on  the  isthmus  of  Panama,  to  unusual  vicissi- 
tudes of  weather,  and  three  weeks  after  he  left  Panama  had 
sickened  with  chill,  fever,  vomiting,  etc.,  more  or  less 
severe,  which,  however,  he  succeeded  in  suppressing  by 
large  doses  of  quinine,  so  as  to  be  able  to  travel  for  a  few 
days  at  a  time.  Three  days  before  I  saw  him  he  was  taken 
with  an  unusually  severe  chill,  followed  by  high  fever  and 
alternations  of  chill  and  fever,  with  severe  constitutional 
symptoms,  which  continued,  notwithstanding  large  and  re- 
peated doses  of  quinine,  until  I  found  him  in  the  following 
condition : 

Though  still  quite  stout  he  had  lost  flesh  greatly,  having 
decreased  in  weight  thirty  pounds  during  the  last  month. 
His  face  was  of  a  dusky  red  hue,  hot  and  dry,  eyes  injected, 
dry  and  ferrety,  the  pupils  contracted,  with  a  very  restless, 
anxious  expression.  The  patient  had  constant  thirst,  though 
satisfied  with  a  single  swallow  of  water  at  a  time.  The 
stomach  was  excessively  irritable — drink  was  rejected  as 
soon  as  taken  ;  a  profound  disgust  for  food  of  all  kinds.  The 
tongue  was  covered  with  a  thick,  brownish  coat,  and  felt  to 
the  patient  dry,  though  not  actually  so.  When  protruded, 
the  tongue  trembled  and  was  moved  involuntarily  back  and 
forth,  in  spite  of  efforts  to  keep  it  still.  The  hands  trembled 
excessively  when  held  out,  and  the  patient  complained  of 
indescribable  weakness  and  prostration.  Nevertheless,  there 
was  uncontrollable  restlessness,  it  being  literally  impossible 
to  remain  for  more  than  an  instant  in  one  position — the 


480  PANAMA   FEVER   CURED   BY   ARSENICUM. 

recumbent  posture  was  intolerable ;  alternations  of  chill 
and  heat,  partial  and  fugitive  in  character,  were  experienced, 
each  lasting  about  fifteen  minutes,  the  heat  yielding  for  a 
few  moments  to  a  partial,  clammy  sweat,  which  was  soon 
succeeded  by  chill  again.  There  were  dyspnoea  and  short, 
dry  cough.  The  spleen  was  much  enlarged  and  dull  on 
percussion.  During  the  last  two  nights  the  patient  had 
been  unable  to  sleep  at  all,  but  had  been  exceedingly  rest- 
less and  uncomfortable,  tormented  by  thirst.  The  pulse  was 
140,  very  quick,  small  and  wiry.  The  head  was  confused, 
and  I  found  the  sensorium  much  clouded,  it  being  difficult 
to  get  definite  answers  to  my  questions ;  there  was,  how- 
ever, a  constant  effort  to  give  expression  to  a  sense  of  great 
uneasiness  and  vague  apprehension  of  severe  illness. 

No  one  who  has  been  at  all  conversant  with  Panama 
Fever  could  fail  to  recognize  the  gravity  of  the  above.  I 
expected  to  have  a  long  and  perhaps  a  doubtful  battle  with 
the  disease,  and  proceeded  accordingly  to  make  arrange- 
ments for  an  indefinite  sojourn  on  the  part  of  my  patient, 
who.  was  not  a  resident  of  this  place.1  From  the  symptoms 
as  detailed,  there  could  be  no  doubt  of  the  prescription 
required  at  the  moment.  The  excessive  prostration,  con- 
joined with  the  great  nervous  and  vascular  erethism,  the 
irritability  of  the  stomach,  the  great  thirst,  satisfied  for  the 
moment  by  a  small  quantity  of  water, — the  intermingled 
heat,  chill  and  partial  sweat,  presenting  at  no  time  a  definite 
paroxysm  of  intermittent, — along  with  the  dyspnoea  and 
anxiety,  and  the  peculiar  pulse,  weak  and  yet  excited,  made 
it  a  matter  of  course  that  I  should  give  Arsenicum,  which 
as  the  indications  were  so  clear  that  the  selection  of  the 
remedy  could  not  be  a  matter  of  doubt,  I  gave  in  the  two 
hundredth  potency,  deeming  this  a  very  fair  case,  both  as 
regards  the  clearness  of  indication  and  the  severity  of  the 
disease,  for  the  demonstration  of  the  power  of  the  high 
potencies.  I  gave  at  4  P.  M.  a  powder  of  Saccharum  lactis 
1  Newburgh,  N.  Y. 


PANAMA   FEVER   CURED   BY   ARSENICUM.  481 

containing  ^two  globules  of  Arsenicum200,  to  be  taken  dry, 
and  to  be  followed  by  a  similar  powder  every  four  hours. 

The  following  day  I  found  that  my  patient  had  slept 
three  hours  the  night  before ;  his  stomach,  no  longer 
irritable,  tolerated  beef  tea  and  toast,  the  chills  and  heat 
occurred  about  once  in  four  hours,  lasting  for  a  few  moments 
only;  cough  and  dyspnoea  had  disappeared.  Prostration 
still  excessive,  restlessness  moderate,  intelligence  good, 
tongue  and  hands  less  tremulous.  Arsenicum200  as  before, 
every  six  hours. 

The  third  day.  A  better  night,  no  chills  or  heat  to-day, 
strength  increasing;  no  restlessness.  Arsenicum200  every 
eight  hours. 

The  fourth  day.  Slept  well  last  night,  feels  like  walking 
out ;  appetite  good,  tongue  clean.  Saccharum  lactis. 

The  fifth  day.     Feels  quite  well  and  strong. 

The  next  day  he  resumed  his  journey.  In  such  a  case, 
one  would  apprehend  a  relapse  after  the  expiration  of  one, 
two  or  three  weeks.  I  have  made  -especial  inquiries  respect- 
ing my  patient,  and  find  that  nothing  of  the  kind  has 
occurred.  It  is  three  months  since  I  prescribed  for  him, 
and  he  has  steadily  gained  strength  and  flesh,  and  is  to  all 
appearance  well. 


•    A  CASE  CURED  BY  MAGNESIA  CARBONICA. 


Mrs.  S.,  aged  twenty- seven  years,  fair  and  stout,  has  been 
married  six  years,  but  never  pregnant.  Before  marriage, 
menstruation  was  normal ;  soon  after  marriage,  it  became 
irregular,  as  follows  :  menses  would  appear  at  intervals  of 
three  or  four  months,  and  the  flow  would  continue,  with 
scarcely  an  intermission,  for  twelve  or  fourteen  weeks.  The 
discharge  was  generally  dark  and  thick,  accompanied  by 
pain,  more  or  less  severe.  During  the  flow  the  patient 
became  quite  feeble  and  anaemic,  although  not  apparently 
emaciated. 

She  applied  to  me,  March  16,  stating  that  she  had  been 
flowing  since  March  1st;  the  discharge  being  thick,  dark  and 
abundant,  and  attended  by  unusually  severe,  labor-like  pains, 
night  and  day.  She  was  already  very  feeble ;  and,  judging 
from  past  experience  that  she  would  continue  to  flow  in  this 
way  for  at  least  two  months,  she  apprehended  a  degree  of 
prostration  that  would  utterly  disable  her.  I  gave  Platina200, 
a  dose  every  night.  The  flow  continued,  although  daily 
diminishing  in  quantity,  for  one  week,  and  then  ceased. 
The  patient  immediately  began  to  regain  strength.  There 
was  no  re-appearance  of  menses  until  June  16,  when  they 
came  on  as  before,  but  without  pain,  continued  two  days, 
ceased  for  twenty-four  hours,  re-appeared,  and  continued 
until  July  4.  During  this  time  Platina200  was  taken  as 
before.  July  18,  menses  re-appeared,  the  flow  being  very 
abundant,  dark,  and  somewhat  coagulated.  The  patient 
was  weak,  had  no  appetite,  and  complained  of  pain  and 
much  commotion  in  the  abdomen.  Platina  having  failed  to 
produce  a  lasting  effect,  China,  Crocus,  and  Hamamelis  were 


A   CASE   CURED   BY   MAGNESIA   CARBONICA.          483 

given,  but  without  satisfactory  results.  The  flowing  con- 
tinued from  July  18  to  September  12,  when  the  patient's 
condition  of  debility  was  quite  deplorable.  I  now  found 
her  symptoms  to  be  as  follows  :  the  flow  was  not  quite  so 
dark,  very  profuse,  but  much  more  profuse  during  the  night 
and  on  first  rising  than  it  was  during  the  day.  On  rising  in 
the  morning,  the  patient  experienced  a  contracting  pain  in 
the  abdomen,  and  a  sharp  upward  stitch  in  the  rectum, 
followed  by  a  discharge  of  coagula  from  the  vagina.  There 
was  not  much  flowing  during  the  day,  while  throughout  the 
night  it  was  abundant.  She  was  very  weak,  and  had  much 
headache  and  no  appetite.  I  gave  Mag'nesia  carbonica200,  to 
be  dissolved  in  water,  a  tea-spoonful  every  four  hours  until 
better.  September  16,  she  reported  that  after  taking 
Magnesia  carbonica  for  two  days  the  flowing  at  night 
ceased  ;  now,  after  four  days,  the  flowing  had  entirely  ceased. 
The  improvement  in  general  condition  had  been  remarka- 
ble. From  this  time,  the  progress  of  the  patient  was  all  that 
could  be  desired.  In  five  weeks  menstruation  re-appeared 
and  pursued  a  normal  course,  and  there  has  been  no  recur- 
rence of  the  former  long-standing  troubles. 

The  prescription  of  Magnesia  carbonica  in  this  case  was 
followed  by  very  prompt  and  complete  relief.  The  symp- 
tom which  led  to  it  was  the  "  condition  "  of  the  flowing,  viz.: 
"  worse  during  the  night."  Shall  we  now,  on  the  strength 
of  this  conformation  of  this  unusual  (we  might  say  unphysi- 
ological)  symptom,  pronounce  the  latter  a  "  characteristic," 
or  a  "key-note  "  of  Magnesia  carbonica  ?  It  was  certainly 
the  symptom  in  the  case  which  struck  me  as  most  remarka- 
ble (for  I  do  not  remember  meeting  it  before  in  practice), 
and  the  fact  that  I  found  it  in  the  proving  of  Magnesia  car- 
bonica determined  me  to  give  that  remedy.  But  would  it  be 
safe  to  rely  on  this  symptom  alone  as  a  "  key-note  "  and 
always  give  Magnesia  carbonica  when  we  meet  the  symp- 
tom in  practice?  No  doubt  we  should  sometimes  brilliantly 
succeed,  but  I  am  sure  we  should  often  fail.  At  least  one 


484  A   CASE   CURED   BY   MAGNESIA   CARBONICA. 

other  remedy  has  the  same  symptom,  flowing  worse  at  night, 
viz.,  Bo  vista;  and  still  others  may  have  it.  Between  these 
two  remedies,  the  distinction  is  easily  found  in  the  diversity 
of  the  other  symptoms. 

Magnesia  carbonica  produces 1  too  frequent  and  too 
profuse  menstruation;  the  flow,  which  is  dark  and  thick, 
being  more  profuse  at  night,2  corresponds  with  my  case  in 
every  particular. 

Bovista,  on  the  other  hand,3  makes  menstruation  tardy  and 
scanty  ;  the  flow,  which  is  watery,  being  most  abundant  at 
night.4 

These  remedies,  so  different,  agree  in  this  one  symptom, 
"increase  of  flowing  at  night."  We  could  avoid  error  in  a 
prescription  only  by  taking  cognizance  of  the  totality  of  the 
symptoms, —  Hahnemann's  approved  method.  Should  we 
venture  to  base  a  prescription  on  this  remarkable  symptom 
alone,  as  a  characteristic  or  "key-note,"  we  should  probably 
fail  in  half  our  cases. 

Ex  uno  disce  omnes.  There  is  no  royal  road  to  knowledge 
of  the  Materia  Medica. 


1  Chronic  Diseases,  Symptoms  500  to  Medica,  vol.  iii.,  Bovista;  Symptoms 
525.  382  to  394. 

2  Symptom  510.  4  Symptom  385. 

3  Hartlaub    and    Trinks'    Materia 


.  OVARIAN  TUMOR  CURED  BY  COLOCYNTH. 


On  October  10,  1864,  I  was  requested  to  visit  Mrs.  C.  E. 
H.,  aged  about  thirty-eight  years.  She  gave  me  the  follow- 
ing history :  She  had  been  always  in  good  health,  married 
ten  years,  but  never  pregnant.  While  traveling  in  France 
in  1854,  she  was  attacked  with  what  was  then  called  acute 
peritonitis.  She  was  confined  to  her  bed  several  years. 
Partially  recovering,  she  consulted  Trousseau,  who  discovered 
the  right  ovary  inflamed  and  somewhat  enlarged.  From 
this  time  she  was  more  or  less  unable  to  walk,  and  suffered 
much  from  a  tumor,  which  gradually  developed  in  the  pelvis, 
between  the  uterus  and  the  rectum,  and  which  was  pro- 
nounced by  Trousseau  to  be  an  enlarged  and  prolapsed 
ovary. 

In  1863  she  came  to  New-York,  and  placed  herself  under 
one  of  our  most  experienced  gynecologists,  who  confirmed 
Trousseau's  diagnosis,  pronounced  the  case  incurable,  and 
advised  a  sparing  resort  to  anodynes  to  mitigate  severe  suf- 
fering. I  found  Mrs.  H.  confined  to  her  sofa ;  she  had  not 
left  her  room  for  a  year.  A  firm,  elastic  tumor  occupied  the 
space  between  the  uterus  and  vagina  anteriorly,  and  the 
rectum  posteriorly,  completely  occluding  the  vagina,  and 
rendering  defecation  very  difficult.  It  seemed  not  to  be 
adherent  to  the  walls  of  either  passage.  Attempts  at 
walking  induced  paroxysms  of  acute  pain  across  the  hypo- 
gastrium,  in  the  sacral  region,  and  around  the  hip-joint ; 
from  here  the  pains  extended  down  the  groin  and  along  the 
femoral  nerve.  The  pain  was  relieved  by  flexing  the  thigh 
upon  the  pelvis ;  and  always  induced  or  aggravated  by 
extending  the  thigh.  Even  without  the  provocation  of 


486  OVARIAN   TUMOR   CURED   BY   COLOCYNTH. 

motion  there  were  frequent  and  severe  paroxysms  of  pain, 
as  above  described.  The  appetite  was  not  good,  and 
digestion  feeble;  but  the  general  condition  of  the  patient 
was  good.  Nervous  sensibility  was  very  great.  The  pains 
had  been  ascribed  to  the  pressure  of  the  tumor  upon  the 
sacral  nerves. 

The  patient  had  a  dread  of  taking  opiates,  and  had  used 
them  sparingly.  I  was  requested  to  mitigate  the  pains,  if 
possible, —  no  hope  being  entertained  of  a  cure.  With  no 
definite  expectations  of  accomplishing  a  radical  cure,  I  pre- 
scribed Colocynth200;  a  few  pellets  to  be  taken  whenever  a 
paroxysm  of  pain  came  on,  and  to  be  repeated  every  hour 
during  the  paroxysm.  This  prescription  was  based  on  the 
results  of  the  Austrian  proving  of  Colocynth,  which  confirm 
and  amplify  the  provings  of  Hahnemann. 

November  I .  I  learned  that  the  paroxysms  had  been  less 
frequent,  much  shorter,  and  milder;  the  remedy  appearing 
to  control  them. 

March  I,  1865.  The  patient  walked  half  a  mile  to  my 
office  and  reported  that  she  had  had  no  pain  for  a  month. 
She  could  walk  half  a  mile  daily  without  fatigue  or  pain, 
and  had  resumed  the  charge  of  her  household  after  an 
interval  of  nine  years.  She  thought  the  tumor  had  become 
somewhat  smaller.  Being  about  to  sail  for  Europe,  she 
desired  some  more  Colocynth,  that  she  might  be  provided 
in  case  pain  should  return. 

June  9,  1869.  Mrs.  H.  has  just  arrived  from  Europe.  I 
find  her  perfectly  well.  There  has  been  no  return  of  pain 
since  1865.  The  tumor  disappeared  from  its  position 
between  the  vagina  and  rectum  in  the  autumn  of  1865,  and 
was  plainly  perceptible  in  the  abdomen,  about  as  large  as  a 
Sicily  orange.  It  has  since  disappeared  entirely,  and  nothing 
of  the  kind  can  now  be  discovered.  Was  this  really  an 
ovarian  tumor  ?  No  doubt  appeared  to  be  entertained  by 
the  eminent  physicians  who  preceded  me  in  the  case.  Did 
the  Colocynth  cause  its  absorption  ?  The  patient  has  no 


OVARIAN   TUMOR   CURED   BY   COLOCYNTH.  487 

doubt  on  this  point.  Why  should  it  not  have  done  so  ? 
Because  we  have  no  record  of  any  action  of  Colocynth, 
except  on  the  intestinal  mucous  membrane,  and  on  certain 
plexus  of  nerves  ?  Fortunately,  the  action  of  remedies  is 
not  restricted  to  the  measure  of  our  imperfect  a  priori 
knowledge  of  them. 

A  reviewer  in  the  British  Journal  takes  exception  to  a 
statement  of  mine,  that  a  remedy,  when  indicated  by  a 
well-marked  group  of  symptoms,  will  often  remove,  not 
merely  those,  but  also  other  groups  apparently  unconnected, 
— in  fact,  the  whole  disease.  This  case  is  in  point.  And  yet 
I  can  hardly  doubt  that,  in  such  cases,  a  complete  proving, 
were  it  possible,  would  show  that  the  remedy  does  produce 
likewise  these  seemingly  unconnected  symptoms, — in  fact,  a 
picture  of  the  whole  disease,  Indeed,  on  examining  the 
Austrian  proving,  we  find  Frolich  reports  two  brief  prov- 
ings  on  women,  both  of  which  show  the  action  of  Colocynth 
on  the  ovaries.  Had  we  well-instructed  women-provers, 
how  much  more  we  should  know  of  the  action  of  drugs ! 


BAPTISIA    AS    A    HAIR-WASH. 


Miss  A.  S.,  forty-two  years  old,  of  light  complexion, 
spare  figure,  very  excitable,  and  prone  to  dwell  upon  her 
own  ailments  and  disabilities,  consulted  me  in  December, 
1 864,  for  chronic  constipation ;  to  palliate  which,  she  had 
been  in  the  habit  of  taking  daily,  a  pill  of  extract  micis 
vomica  and  aloes. 

Under  the  use  of  sulphur200,  followed  by  albumina200,  she 
became  able  to  dispense  with  her  purgative  pill,  having  a 
regular  stool  every  day. 

On  the  2Oth  February,  i8"65,  she  applied  to  me  again  with 
the  following  symptoms : 

"  The  day  before,  her  eyes  began  to  smart  and  feel  as 
though  she  had  been  exposed  to  wood-smoke.  They  felt 
full  of  dust;  the  conjunctiva  of  the  globe  was  injected ;  there 
was  a  discharge  of  muco-purulent  matter  from  the  eyes  this 
morning. 

"  Fluent  coryza,  the  discharge  being  thin,  not  acrid,  a 
sore  spot,  feeling  raw,  internally  on  the  left  side  of  the 
pharynx ;  these  symptoms  are  aggravated  by  exposure  to 
damp,  cool  air.  Headache,  a  pressure  backward  in  the 
entire  frontal  region ;  severe  pain  from  the  right  side  of  the 
occiput  to  the  right  frontal  protuberance. 

"  She  feels  ill,  in  an  undefinable  way ;  feels  weak ;  half 
depressed  in  spirits,  half  apprehensive  of  some  coming  evil. 
Feels  as  though  some  unknown  but  irresistible  influence  had 
possession  of  her  and  she  were  about  to  be  ill,  or  to  meet 
with  some  misfortune." 

Her  face  was  flushed,  but  there  was  no  heat  of  skin ;  the 
pulse  was  about  eighty,  soft  and  slightly  irregular. 


BAPTISIA   AS   A   HAIR-WASH.  489 

Something,  I  cannot  tell  what,  struck  me  as  incongruous 
in  the  patient's  appearance  and  symptoms,  and  led  me  to 
doubt  whether  her  condition  were  an  idiopathic  disease.  I 
said  to  her,  "  You  seem  to  me  to  be  under  the  influence  of 
some  drug  or  poison.  What  have  you  taken  ?"  She  pro- 
tested that  she  had  taken  no  medicine.  The  similarity  of 
her  condition  to  my  idea  of  the  symptoms  of  Baptisia,  came 
forcibly  to  my  mind,  and  I  asked,  "  Have  you  not  taken  or 
in  some  way  used  the  tincture  of  the  Baptisia?"  After 
some  hesitation,  she  replied :  "I  have  been  using  for  several 
days  a  hair- wash,  composed  chiefly  of  the  tincture  of  Wild 
Indigo.  Could  that  have  anything  to  do  with  my  symp- 
toms?" 

I  forbade  the  hair- wash,  and  gave  nitric  acid™. 

A  week  passed  before  the  symptoms  disappeared,  those 
of  the  eyes  lingering  longest. 

NEW- YORK,  Dec.  i,  1867. 


CHLORINE  IN  SPASMUS  GLOTTIDIS.     No.   i. 


In  the  year  1850,  after  submitting  to  the  manipulations  of 
a  dentist,  I  was  advised  to  wash  the  mouth  with  a  solution 
of  Chlorine.  A  weak  solution  of  Chlorine  gas  in  cold  water 
was  accordingly  prepared,  and  I  proceeded  to  rinse  the 
mouth  with  it.  Scarcely  had  the  liquid  been  received  into 
my  mouth,  when  I  became  sensible  of  a  spasmodic  action  of 
some  part  of  the  respiratory  organs  of  the  following  charac- 
ter :  Inspiration  was  unimpeded,  and  could  be  effected  in 
the  natural  manner,  but  expiration  was  absolutely  impossible, 
and  this  impossibility  arose,  if  I  might  trust  my  sensations, 
not  from  any  inability  of  the  muscles  of  expiration,  but  from 
a  closure  of  the  rima  glottidis.  Expiration  being  felt  to  be 
impossible,  inspiration  was  again  attempted,  and  was  accom- 
plished, fully  and  easily,  although  the  act  was  attended 
by  a  slight  crowing  noise.  Expiration,  which  was  again 
attempted,  was  impossible  as  before.  By  these  successive 
operations,  the  lungs  became  inflated  to  a  most  painful 
degree,  but,  so  firmly  did  the  glottis  appear  to  be  closed, 
that  it  seemed  as  though  air  might  pass  through  any  part 
of  the  thoracic  walls  more  readily  than  by  the  way  of  the 
larynx.  This  arrest  of  respiration  having  endured  for  about 
a  minute,  the  face  becoming  turgid  and  livid,  partial  coma 
supervened,  the  spasm  relaxed,  and  respiration  became  free 
again. 

In  1852,  I  had  an  opportunity  of  witnessing  the  effect 
of  a  strong  accidental  inhalation  of  chlorine  gas  by  an  adult. 
The  same  phenomena  of  comparatively  free,  but  crowing 
inspiration,  and  of  absolutely  obstructed  expiration  presented 
themselves ;  the  face  became  extremely  livid,  convulsive 


CHLORINE   IN   SPASMUS   GLOTTIDIS.      NO.    I.         491 

movements  of  the  extremities  began,  and  the  patient  became 
partially  comatose.  I  administered  ammonia  by  olfaction ; 
the  spasm  relaxed,  and  consciousness  returned  along  with 
normal  respiration. 

These  experiments  show  a  power  in  chlorine  to  produce 
the  following  condition :  Spasm  of  the  glottis,  which  inter- 
feres but  little  with  inspiration,  giving  to  it  a  crowing  sound, 
but  which  prevents  expiration.  During  the  continuance  of 
the  spasm,  the  respiratory  acts  consist  of  a  succession  of 
crowing  inspirations,  each  followed  by  an  ineffectual  effort  at 
expiration,  the  whole  serving  to  inflate  the  chest  to  a  most 
painful  extent,  and  attended  at  last  by  turgescence  of  the 
face,  and  more  or  less  complete  coma,  with  or  without  con- 
vulsive movements  of  the  extremities,  and  during  which  the 
spasm  relaxes. 

In  the  Proving  of  Chlorine/  a  similar  effect  is  indistinctly 
indicated.  Pereira  says :  "  If  an  attempt  be  made  to  inhale 
undiluted  chlorine  gas,  it  produces  spasm  of  the  glottis. 
Twice  I  have  suffered  severely  from  the  accidental  inhala- 
tion of  it;  and  each  time  it  gave  the  sensation  of  constric- 
tion of  the  air-tubes,  such  as  might  be  produced  by  a 
spasmodic  condition  of  the  muscular  fibers  of  the  bronchial 
tubes."  The  peculiar  nature  of  the  chlorine  spasm,  viz., 
that  it  affects  expiration  almost  exclusively,  is  not  mentioned 
by  Pereira. 

Bearing  in  mind  the  odium  which  has  been  attempted  to 
be  cast  upon  some  of  our  colleagues  for  flooding  our  litera- 
ture with  "fragmentary  provings,"  which  serve  no  purpose 
but  to  "  cumber  the  Materia  Medica,"  and  to  annoy  our 
practitioners  with  an  "  emb arras  de  richesses"  (as  if  it  were 
not  worth  while  to  publish  and  to  study  anything,  however 
"  fragmentary,"  if  it  furnish  us  the  means  of  curing,  were  it 
but  a  single  case  ! ),  I  might  have  abstained  from  publishing 
the  above  symptoms  of  Chlorine,  had  not  the  following  case 
demonstrated  their  practical  value. 

1  In  vol.  ii.  of  the  Ncues  Archiv. 


492         CHLORINE   IN   SPASM  US   GLOTTIDIS.      NO.    I. 

June  24th.  A  female  infant,  seven  months  old,  well  devel- 
oped and  large,  the  fourth  child  of  healthy  parents,  was 
brought  to  me  with  the  following  history :  Having  been 
previously  in  perfect  health,  she  was  seized  three  weeks 
ago,  with  a  spasmodic  affection  of  the  respiratory  organs. 
Suddenly  and  without  any  warning,  she  would  make  a  long 
inspiration,  with  a  slight  crowing  noise ;  an  attempt  to 
exhale  would  be  made,  but  without  success  ;  another  crow- 
ing inspiration  followed  by  a  forcible,  but  ineffectual  effort  to 
exhale  ;  and  this  would  be  repeated  until  the  child  became 
blue  around  the  mouth,  and  sank  into  partial  uncons- 
ciousness, when  free  respiration  would  take  place,  and  the 
child  would  generally  sink  into  a  deep  sleep.  Frequently 
toward  the  close  of  an  attack,  convulsive  movements  of  the 
extremities  would  be  noticed,  and  once,  general  spasm 
occurred.  At  first,  these  attacks  came  on  only  after  some 
excitement,  or  on  the  child  being  startled.  They  frequently 
occurred  during  sleep,  arousing  the  child  suddenly,  and  they 
were  most  frequent  from  midnight  to  7  A.  M.  Within  the 
week  before  I  saw  her,  they  had  become  very  frequent — as 
many  as  thirty  to  forty,  occurring  during  the  twenty-four 
hours.  The  child  had  begun  to  emaciate  rapidly,  had  lost 
appetite,  strength  and  playfulness,  the  face  was  pale  and 
bloated,  and  the  eyes  had  a  dull  and  glassy  expression. 
The  child  had  been  under  most  skillful  homoeopathic  treat- 
ment since  the  commencement  of  the  attacks,  and  as  she 
failed  to  improve,  change  of  air  was  recommended,  and  she 
was  brought  to  Newburgh.  The  climate  failing  to  benefit 
her,  the  child  was  placed  under  my  care.  The  case  seemed 
all  the  more  serious  from  the  fact  that,  last  year,  the  parents 
had  lost  an  older  child,  a  boy,  with  the  same  affection.  In 
the  fourth  week  of  the  disease,  of  which  the  course  had  been 
in  every  respect  similar  to  that  of  the  infant  above  narrated, 
convulsions  supervened,  and  the  child  died  at  the  end  of  the 
sixth  week.  This  child  was  under  enlightened  allopathic 
care.  It  may  be  interesting  to  note,  that  the  autopsy 


CHLORINE   IN   SPASMUS    GLOTTIDIS.        NO.    I.       493 

revealed  no  malformation,  and    no    organic   lesion ;  simply 
emaciation  and  atrophy. 

On  careful  examination  of  my  little  patient,  I  could 
discover  nothing  abnormal  in  the  condition  of  the  heart  or 
lungs,  and  no  sign  of  disease  that  was  not  fairly  attributed 
to  the  frequent  recurrence  of  these  spasms,  with  the  venous 
congestion  consequent  upon  them.  It  was  evidently  a  case 
of  spasmus  glottidis  (asthma  thymicum,  asthma  millari, 
asthma  laryngeum  infantum,  laryngismus  stradulus),  and 
had  advanced  almost  to  the  second  or  convulsive  stage  in 
which  the  prognosis  is  decidedly  unfavorable. 

The  remedy  which  is  recommended  before  all  others  for 
this  disease,  in  our  hand-books  and  repertories,  is  Sambucus. 
The  symptom  on  which  this  recommendation  is  based  is  the 
following:  "Slumber  with  half-open  eyes  and  mouth;  on 
awaking  from  it,  he  could  not  draw  a  breath,  and  was 
compelled  to  sit  up,  whereupon  respiration  was  very  hurried, 
with  wheezing  in  the  chest,  as  if  he  should  suffocate ;  he 
lashed  about  with  his  hands ;  the  head  and  face  were 
bloated  and  bluish  ;  he  was  hot,  without  thirst ;  weeping  at 
the  approach  of  a  paroxysm, — all  this  without  cough,  and 
especially  at  night,  from  twelve  to  four  o'clock."  On  com- 
paring this  picture  with  the  case  under  consideration,  we 
find  correspondences  in  the  general  characters  of  the  affec- 
tion. The  spasmodic  embarrassment  of  respiration,  the 
absence  of  fever  and  of  cough,  the  occurrence  of  the 
paroxysms  suddenly,  chiefly  at  night,  and  on  awaking,  show 
a  general  appropriateness  of  Sambucus  to  spasms  of  the 
larynx  and  bronchial  tubes.  But  we  seek  in  vain  for  the 
unequal  disturbance  of  the  inspiratory  and  the  expiratory  acts, 
which  are  the  individual,  and  therefore  the  characteristic, 
peculiarity  of  the  case  under  consideration.  And  failing  to 
find  this,  we  should,  as  a  matter  of  course,  expect  that 
Sambucus  would  fail  to  cure,  or  in  any  way  to  affect  the 
case.  And  this  had  been  the  fact.  So,  too',  of  Lachesis 
and  several  other  remedies  which,  as  well  as  Sambucus,  had 


494         CHLORINE    IN    SPASMUS    GLOTTIDIS.      NO.    I. 

already  been  tried  before  the  case  came  under  my  care. 
In  this  very  peculiarity,  which  was  characteristic  of  the  case, 
the  similarity  of  Chlorine  was  most  striking.  And  it  was 
with  the  utmost  confidence  of  a  happy  result,  that  I  deter- 
mined, after  a  careful  examination  of  the  case,  to  administer 
Chlorine.  I  accordingly  prepared  a  saturated  solution  of 
Chlorine  gas  in  water  at  60°  Fahrenheit,  and  made  from 
this  the  first  centesimal  dilution,  in  which  the  odor  of  the 
Chlorine  could  be  faintly  perceived. 

Of  this  I  ordered  twenty  drops  to  be  dissolved  in  four 
table-spoonfuls  of  water,  and  a  tea-spoonful  to  be  given  to  the 
child  every  three  hours.  (A  porcelain  spoon  was  used.)  I 
also  directed  a  few  drops  to  be  placed  in  the  child's  mouth 
at  the  beginning  of  each  paroxysm,  if  this  should  be 
possible. 

The  first  dose  was  given  at  four  P.  M.,  June  24th.  During 
the  preceding  twenty-four  hours  the  child  had  had  forty 
paroxysms.  During  the  succeeding  twenty-four  hours  there 
occurred  but  four  paroxysms,  only  one  of  which  began  with 
any  severity,  and  this  one  was  instantly  arrested  midway  by 
a  few  drops  of  the  solution  placed  upon  the  child's  tongue. 
During  the  night  of  the  26th  not  a  single  paroxysm.  Im- 
provement in  the  general  condition  of  the  patient  now 
became  apparent ;  appetite  and  playfulness  returned ;  the 
bloated  aspect  of  the  face  and  the  dullness  of  the  eye  dis- 
appeared. On  the  2/th  the  paroxysms  increased  in  number 
and  severity.  On  examining  the  solution,  I  found  that  it 
had  changed  in  character,  and  no  longer  contained  Chlorine. 
A  fresh  solution  was  prepared,  and  thenceforward  it  was 
prepared  afresh  every  second  day.  From  this  time,  July 
1st,  the  remedy  was  continued ;  a  dose  every  four  hours, 
when,  the  spasms  having  wholly  ceased,  and  the  child 
appearing  well,  it  was  finally  discontinued.  On  the  2d  July 
a  slight  spasm  occurred,  and  the  child  appeared  feverish  and 
excited,  with  greenish  diarrhoea.  I  found  a  lower  incisor 
pressing  strongly  upon  the  gum,  which  was  hot  and  swollen, 


CHLORINE   IN    SPASMUS   GLOTTIDIS.      NO.    I.         495 

and  which  I  forthwith  lanced.  In  two  hours  the  child  had 
lost  every  trace  of  illness.  Since  this  date  she  has  continued 
in  good  health,  with  the  exception  of  some  trifling  disorder 
attendant  upon  dentition.1  There  has  been  no  sign  of  a 
recurrence  of  the  spasm  of  the  glottis. 

I  am  aware  that  children  who  are  subjects  of  this  disease 
have  occasionally  periods  of  exemption  from  its  attacks, 
though  this  is  not  the  case  when  the  attacks  are  so  frequent 
and  also  violent  as  in  the  above  case,  and  it  is  possible  that 
this  child  may  be  again  attacked  under  provocation  of  diffi- 
cult dentition  or  of  some  equally  powerful  exciting  cause. 
As  there  can  be  no  doubt,  however,  of  the  controlling  power 
of  chlorine  over  the  first  attack,  I  should  have  no  misgivings 
about  its  success  in  subsequent  attacks,  should  the  condition 
be  the  same  as  before. 

In  connection  with  the  above  remarks  upon  Chlorine,  it 
may  not  be  amiss  to  call  attention  to  a  kind  of  spasm  of  the 
glottis  occasionally  produced  by  chloroform,  and  which 
strikingly  resembles  the  spasms  produced  by  Chlorine.  Now, 
by  the  presence  of  an  alkaline  solution,  chloroform  is  readily 
decomposed,  and  Chlorine  set  free.  The  question  at  once 
suggests  itself  whether  in  these  cases  of  spasms  such  a 
decomposition  has  been  induced  by  the  reaction  of  the 
alkaline  saliva  upon  the  vapor  of  chloroform,  and  whether 
the  spasm  is  caused  by  the  Chlorine  thus  set  free. 

In  this  case,  the  spasm  of  the  glottis  constituted  the  whole 
of  the  morbid  condition.  But  sometimes  spasm  of  the 
glottis  occurs  as  a  complication  of  some  affection  of  the 
throat  or  of  the  respiratory  apparatus,  and  in  such  cases 
Chlorine  may  be  of  great  service.  In  the  winter  of  1853,  I 
visited  in  consultation  a  case  of  scarlatina,  in  which  slough- 
ing of  the  pharynx  to  a  great  extent  had  taken  place  and  in 

1  Marshall  Hall  advises,  that  in  this  even  daily  scarifications,  of  the  gums, 

disease   special  attention    should    be  Until  the  2d  of  July  there  was  no  sign 

paid  to  the  state  of  the  gums,  if,  as  is  of  irritation  of  the  gums,  which  had 

generally   the   case,  it    occur   during  been  carefully  examined  by  me  every 

dentition,   and    he    advises    frequent,  day. 


496        CHLORINE  IN   SPASMUS   GLOTTIDIS.      NO.    I. 

which  spasm  of  the  glottis  had  set  in,  threatening  to  cause  a 
speedily  fatal  termination.  The  attacks  of  spasm  were 
almost  constant,  the  child,  a  boy  of  eight  years,  scarcely 
rallying  from  one  paroxysm  before  another  came  on.  The 
character  of  the  spasm  was  precisely  such  as  I  had  seen 
produced  by  Chlorine.  Chlorine  water  was  administered, 
and  the  spasms  ceased  instantly,  with  but  one  or  two  very 
slight  recurrences. 


CHLORINE  IN  SPASMUS  GLOTTIDIS.     No.  2. 

More  than  three  years  ago,  I  published1  an  account  of 
the  effects  of  the  inhalation  of  Chlorine  gas  in  two  instances, 
with  the  record  of  a  case  in  which  the  symptoms  of  the 
disease  were  so  similar  to  the  effects  which  I  had  witnessed 
and  experienced  from  the  inhalation  of  Chlorine,  that  I  was 
induced  to  administer  a  solution  of  Chlorine  gas  in  water. 
The  case  was  rapidly  cured.  The  following  case  furnishes 
additional  evidence  of  the  value  of  Chlorine  in  certain  spas- 
modic affections  of  the  glottis : 

December  I2th,  1862.  J.  S.,  aged  fifty-two  years,  has 
suffered  from  follicular  pharyngitis ;  has  had  the  larynx  and 
fauces  swabbed,  burned  and  penciled  with  nitrate  of  silver 
until  he  could  endure  it  no  longer.  For  two  years  he  has 
not  been  under  medical  treatment.  He  now  suffers  much 
from  pain  in  the  throat,  and  has  an  habitual  cough  and 
expectoration  of  glairy  mucus.  Within  three  days  the  cough 
has  assumed  a  spasmodic  character,  with  the  following 
peculiarities  : 

The  desire  to  cough  results  from  a  tickling  and  a  sensation 
of  rawness  behind  the  thyroid  cartilage.  When  the  patient 
seeks  to  yield  to  this  desire,  he  finds  it  impossible  to  expel 
the  air  from  the  chest,  as  is  required  in  the  act  of  coughing. 
The  cough  is  therefore  abortive,  although  the  desire  grows 
continually  more  and  more  intense.  The  obstruction  to  the 
free  and  sudden  expulsion  of  air,  which  would  constitute  a 
cough,  he  describes  as  resulting  from  an  apparent  constriction 
just  below  the  larynx.  At  the  same  time  he  can  draw  air 
into  the  lungs  quite  freely. 

1  Vol.  ii.  of  the  American  Homoeopathic  Review,  1859  :  "  Chlorine  in 
Spasmus  Glottidis.     No.  I." 

33 


498         CHLORINE   IN    SPASMUS   GLOTTIDIS.      NO.    2. 

This  freedom  of  inhalation  and  impeded  exhalation, 
together  with  the  constantly  increasing  tickling  in  the  larynx 
which  compelled  the  patient  to  make  very  energetic  but 
unavailing  efforts  to  cough,  continue  until  he  sinks,  ex- 
hausted and  covered  with  sweat,  upon  a  couch,  when  the 
spasm  seems  to  relax  and  he  can  cough  and  exhale  with 
comparative  freedom.  These  paroxysms  recur  about  every 
two  hours. 

I  prepared  immediately  a  weak  solution  of  Chlorine  gas 
in  cool  water,  so  weak  that  the  odor  of  the  gas  could  scarcely 
be  detected,  and  when  one  of  the  paroxysms  was  at  its 
height,  administered  a  tea-spoonful.  '  The  effect  was  magical. 
The  spasm  relaxed  immediately  and  the  tickling  was  allayed. 
The  dose  was  repeated  every  two  or  three  hours,  as  the 
tickling  recurred,  and  in  the  course  of  twenty-four  hours  the 
disposition  to  a  recurrence  of  the  paroxysms  had  ceased. 

Several  days  afterward  the  patient  applied  to  me  for  a 
quantity  of  "that  solution,"  stating  that  since  h^  had  taken 
it,  his  throat  had  been  more  comfortable  and  his  voice  better 
than  they  had  been  since  the  day  when  he  was  unhappily 
persuaded  to  allow  caustic  to  be  applied  to  his  throat. 


CHLORINE  IN  SPASMUS  GLOTTIDIS.     No.  3.  . 

Several  years  since  I  published1  an  accidental  proving  of 
Chlorine,  with  some  cases  of  spasm  of  the  glottis  in  which 
I  had  used  it  with  advantage. 

Last  month  I  was  called  to  a  child,  two  years  and  a  half 
old,  which  had  just  been  brought  home  from  the  country, 
and  was  supposed  to  be  at  the  point  of  death.  Five  weeks 
before,  it  had  sickened  with  scarlatina,  which,  according  to 
the  physicians  in  attendance,2  had  become  complicated  by 
diphtheria,  and  this  by  inflammation  of  the  right  lung  and 
deposit  therein.  An  abscess  had  formed  and  discharged 
externally  on  the  neck;  leaving  an  ulcer  about  two  inches 
long  and  one  and  a  half  broad,  which  exposed  the  cervical 
muscles,  and  showed  no  disposition  to  heal ;  copious  and 
very  offensive  discharge  from  both  ears ;  the  throat  seemed 
to  be  full  of  a  thick,  yellow  matter,  very  offensive,  which 
the  child  would  occasionally  eject,  but  seemed,  for  the  most, 
to  be  unable  to  move  either  up  or  down.  .  Any  attempt 
to  examine  the  throat,  or,  on  the  part  of  the  child,  to 
open  the  mouth  to  take  food  or  drink,  or  any  attempt  to 
cough,  produced  a  fearful  spasm  of  the  glottis,  which  seemed 
to  admit  the  air  well  enough  but  to  prevent  its  exit,  and 
which  lasted  until  the  child  became  livid  and  sank  exhausted. 
And  this  constituted,  in  the  opinion  of  my  predecessors,  the 
insuperable  obstacle  to  the  child's  recovery.  The  spasm 
prevented  its  tasting  food.  No  food  had  been  taken  for 
a  week,  and  very  little  during  the  entire  illness.  The  child 
was  now  very  feeble  and  greatly  emaciated.  Its  death  had 
been  hourly  looked  for  by  the  doctors. 

1  American    Homoeopathic     Review,          2  Allopaths  of  excellent  professional 
vol.   ii.,  pp.   18  and  448:    "  Spasmus      standing. 
Glottidis.     No.  i." 


5OO         CHLORINE   IN    SPASMUS    GLOTTIDIS.       NO.    3. 

I  prepared  immediately  some  Chlorine  water,1  diluted, 
until  the  gas  was  just  perceptible,  and  gave  to  the  child. 
He  took  a  mouthful  and  began  to  choke  with  the  spasm ; 
I  immediately  placed  near  his  face  a  handkerchief,  wet  with 
strong  Chlorine  water,  so  that  he  might  inhale  the  gas. 
The  spasm  ceased  instantly  and  he  swallowed.  I  left  orders 
for  a  similar  procedure  whenever,  from  any  cause,  whether 
coughing  or  swallowing,  the  spasm  should  be  induced.  It 
never  failed  to  arrest  the  spasmodic  action  and  enable  the 
child  to  swallow,  or  to  eject  the  matter  from  the  throat. 
A  number  of  days  elapsed  before  the  child  could  make 
an  articulate  sound,  or  any  sound.  The  doctors  had  thought 
the  diphtheria  had  induced  paralysis  of  some  of  the  pharyn- 
geal  muscles,  and  perhaps  others,  and  hence  the  spasm  in 
the  associate  and  neighboring  muscles.  And  it  may  be  so. 
They  regarded  the  spasm  an  insuperable  obstacle  to  recovery. 
It  was  evident  to  every  attendant  that  the  Chlorine  relaxed 
the  spasm  and  enabled  the  child  to  swallow.  His  subse- 
quent improvement  was  uniform  and  rapid  under  Carbo 
vegetabilis200. 

It  may  be,  by  and  by,  some  esteemed  friend  will  tell 
me2,  "  I  have  used  Chlorine  in  a  case  presenting  exactly 
these  symptoms,  and  it  failed,"  and  may  thence  conclude 
that  I  am  mistaken  in  ascribing  the  successful  issue  of 
my  case  to  Chlorine.  I  suppose  I  shall  reply :  There  are 
two  possible  fallacies.  I  have  stated  the  symptoms  which 
led  me  to  give  Chlorine,  but  they  may  not  comprise  the 
real  symptoms  which  constituted  the  case  a  case  for  Chlorine, 
just  as  the  judge  may  give  a  righteous  judgment,  but 
may  base  it,  in  his  written  opinion,  on  most  erroneous  prem- 
ises. So,  on  the  other  hand,  you,  in  your  case,  may  have 
found  exactly  the  same  symptoms  which  I  described,  but  you 
may  have  overlooked  something  else  in  your  case  which 
constituted  it  an  essentially  different  one  from  mine.  The 

1  American  Homoeopathic  Review,  2  United  States  Medical  and  Sur- 
ii.,  370.  gical  Journal,  vol.  iv.,  p.  408. 


CHLORINE   IN    SPASMUS   GLOTTIDIS.      NO.    3.          5<DI 

sciences  of  pathology  and  semeiology  are  too  imperfect  to 
admit  of  these  back  strokes  of  criticism  overthrowing  posi- 
tive evidence  by  negative.  Why,  they  are  not  admitted 
in  chemistry,  and  hardly,  even  in  astronomy !  I  shall  urge 
these  considerations  in  reply,  but  feebly,  doubtless,  and  to 
no  purpose,  and  shall  at  last  fall  in  with  the  current  of  the 
day,  which,  who  can  resist  ?  and  shall  read  the  old  proverb, 
"Seeing  is  not  believing;"  and  shall  give  in  my  adhesion 
to  the  scientific  motto  of  our  time :  "  Belief  is  human ;  but 
to  doubt  divine." 


ON  THE  ELIMINATION  THEORY.1 


MY  DEAR  DOCTOR:  Your  favor  of  the  nth  inst  was 
received  on  the  I2th.  I  should  have  been  glad  to  send  a 
few  words  of  greeting  to  the  Connecticut  State  Homoeopathic 
Society,  if  I  had  known  earlier  the  date  of  your  meeting. 
As  it  is,  I  have  no  more  time  than  to  call  your  attention  in 
a  few  words  to  the  importance  which  the  "  Elimination 
Theory"  is  now  assuming,  among  the  allopaths,  in  relation 
to  disease  and  its  treatment.  For  centuries  back  it  has 
been  suggested,  every  now  and  then,  by  some  wise  man, 
that  the  secretions  and  excretions  of  patients  are  the  results 
of  efforts  which  nature  is  making  to  get  rid  of  some  poison- 
ous morbific  matter ;  and  that  the  true  indication  is  to  favor 
rather  than  to  check  these  excretions.  But,  in  general,  the 
practice  of  allopaths  has  been  to  check  and  suppress  them, 
as  though  they  regarded  the  discharges  themselves  as  being 
the  disease.  Now,  as  you  must  have  noticed,  Dr.  George 
Johnson,  of  King's  College  Hospital,  London,  a  very  high 
authority,  comes  out  with  a  statement  and  argument  apply- 
ing the  "  Elimination  Theory  "  to  Cholera.  He  holds  that 
the  evacuations  and  vomited  substances  result  from  an  effort 
of  nature  to  get  rid  of  a  poison,  and  that  they  should  be 
encouraged  and  not  be  checked. 

He  opposes  absolutely  the  sedative  and  astringent  treat- 
ment by  opium,  tannin,  kino,  etc.,  and  advises  cathartics 
and  emetics,  and  he  says  that  applying  this  method,  by 
treating  cholera  with  castor-oil,  in  1849  and  1854,  he  gained 
a  very  remarkable  success. 

1  Communication  to  the  Secretary  of  the  Connecticut  State 
Homoeopathic  Society. 


ON   THE   ELIMINATION   THEORY.  503 

Now,  let  it  be  observed  that  the  treatment  of  such  a 
disease  as  cholera  by  purgatives  and  emetics  is,  in  a  certain 
rude  way,  a  homoeopathic  treatment.  The  remedies  which 
we  find  most  successful,  viz.,  Veratrum,  Cuprum,  Ipecacu- 
anha, are  classed  by  allopaths  as  emetics  and  cathartics. 
This  is  another  instance  of  the  fact,  which  has  been  noticed 
in  other  departments  of  pathology  and  therapeutics,  that 
the  most  advanced  medical  philosophy  is  slowly  bringing 
allopaths  round  to  the  same  practical  position  to  which 
Hahnemann's  practical  sagacity  and  observation  led  him 
seventy  years  ago,  before  there  was  a  possible  basis  for 
medical  philosophy  as  it  now  exists. 

One  other  point :  Dr.  George  Johnson,  detailing  his  cases 
of  cholera  treated  by  castor-oil,  says  he  would  have  been 
still  more  successful  had  he  not  erred  by  using  excessive 
doses.  He  found  he  must  use  small  doses.  This  was  Hahne- 
mann's experience  when  he  began  to  prescribe  according  to 
the  homoeopathic  law,  and  it  has  been  the  experience  of 
every  succeeding  experimenter.  And  the  more  strictly  the 
law  is  followed  in  all  minutiae,  the  smaller  must  be  the  dose, 
if  we  would  get  all  possible  good,  avoiding  all  unnecessary 
evil  effects.  It  is  in  this  way  that  homoeopaths  have  been 
gradually  led  to  use,  first  attenuated  medicines,  and  finally 
the  higher  potencies. 


CHOLERA.1 
I. 

There  can  be  no  doubt  that  Asiatic  Cholera,  which  has 
prevailed  during  the  past  summer  in  various  parts  of  Europe, 
has  been  brought  to  our  shores.  Reasoning  from  analogy, 
we  have  good  grounds  for  believing  that  it  will  be  epidemic 
in  the  Atlantic  states  next  summer.  It  is,  therefore,  the 
part  of  prudence  in  us  to  refresh  our  knowledge  of  the 
history  and  character  of  this  terrible  disease,  and  of  the 
causes  which  seem  to  favor  its  propagation,  in  order  that  we 
may  be  the  better  able  to  meet  the  great  practical  problems  : 
HOW  TO  WARD  IT  OFF,  AND  HOW  TO  DEAL  WITH  IT. 

I.  HISTORY.  Like  all  invasions  and  all  epidemics,  cholera 
comes  from  the  East,  marching  westward.  It  is  known  to 
have  existed  in  the  delta  of  the  Ganges  since  1629.  But  in 
1817  it  appeared  in  Hindostan,  as  a  wide-spread  and  terribly 
fatal  epidemic.  From  Calcutta  and  Jessore  its  progress  was 
westward,  although  it  spread  also  into  China  and  the  Indian 
Archipelago.  In  July,  1821,  it  had  reached  Muscat  in 
Arabia,  and  in  1823  it  touched  the  Georgian  frontier  of 

'Of  the  following  paper,  Sections  i.  allopathic  physicians;  as,  for  example, 

to  iv.  were  written  for  and  published  in  Mr.    Wilde,    of    Dublin,   the    distin- 

a  non-medical  journal,  the  Independ-  guished  aural  surgeon,  atul  Dr.  Mc- 

ent,  in  November  and  December,  1865.  Laughlin,   of    London,    Inspector   of 

To   avert   any   possible   charge   of  Cholera     Hospitals    for    the    Golden 
presenting  an  ex  parte  case,  the  testi-  Square  District,  in  1854-55. 
mony  to   the   superiority  of  homreo-  To   these   sections    a  fifth   is   now 
pathic  treatment  in  Cholera  was  chiefly  added,  on  the  Prevention  and  Treat- 
taken  from  the  writings  of  impartial  ment  of  Cholera. — C.  D. 
Government    officers,    or    of   hostile  NEW- YORK,  April  20,  1866. 


CHOLERA.  505 

Russia.  Thence  it  spread  northward  through  Russia,  Poland 
and  Austria,  extending  in  July,  1831,  to  St.  Petersburg  and 
Cronstadt,  and  in  October,  to  Berlin,  Vienna  and  Hamburg. 
In  October,  1831,  it  appeared  in  Sunderland,  England, 
having  been  brought  from  Hamburg.  It  extended  to  Lon- 
don in  February,  1832,  appearing  first  in  the  immediate 
neighborhood  of  the  shipping.  From  England  it  crossed  to 
France,  breaking  out,  March  23d,  in  Paris,  where  in  one 
month  it  carried  off  20,000  persons. 

It  was  conveyed  in  an  emigrant  vessel  from  London  to 
Quebec,  where  it  appeared  June  8,  1832.  A  few  weeks  later 
it  became  epidemic  in  the  city  of  New- York,  where  it  pre- 
vailed with  great  fatality  until  late  in  the  autumn.  It 
re-appeared  in  1834. 

In  1847  and  J848  cholera  again  invaded  Europe  from 
the  East.  December  8,  1848,  the  packet-ship  "New-York" 
arrived  at  quarantine  at  Staten  Island,  N.  Y.,  having  on 
board  a  number  of  passengers  sick  with  cholera.  Several 
had  died  on  the  voyage.  From  this  infection,  cholera  pre- 
vailed at  quarantine  for  several  weeks,  and  two  or  three  cases, 
which  were  traced  to  this  vessel,  occurred  in  this  city. 

Again,  February  13,  1849,  cholera  broke  out  on  board 
the  packet-ship  "Liverpool,"  on  her  way  to  this  port.  There 
were  fifty  cases,  of  which  forty  died.  During  the  succeed- 
ing months  of  spring  and  early  summer,  several  vessels  suc- 
cessively brought  the  disease  to  the  quarantine ;  but  it  did 
not  become  epidemic  in  the  city  of  New- York  until  June, 
1849.  It  prevailed  until  October.  In  the  summer  of  1854 
it  was  again  epidemic  in  New- York. 

In  June,  1865,  we  heard  of  cholera  as  prevailing  at  Mecca, 
and  on  the  route  from  Mecca  to  Alexandria.  It  was  very 
fatal  at  Alexandria,  Cairo  and  Constantinople.  It  extended 
to  Jerusalem  and  along  the  shores  of  the  Mediterranean  and 
Adriatic.  At  Marseilles,  we  have  reason  to  believe,  it  was 
and  is  still  quite  fatal,  although  no  official  reports  have  been 
allowed  to  be  published.  At  the  present  time,  November, 


506  CHOLERA. 

1865,  it  prevails  extensively  in  Paris.  The  cases  which 
recently  arrived  at  our  quarantine  were  from  Paris,  by  way 
of  Havre.  A  few  cases  have  appeared  at  Southampton, 
England.  We  may  hope  that  the  influence  of  winter 
will  prevent  the  malady  spreading  at  present,  but  we 
should  look  for  its  re-appearance  as  an  epidemic  next 
summer. 

The  characteristic  features  of  an  attack  of  Asiatic  cholera 
are,  in  brief,  as  follows :  In  the  chest  and  at  the  pit  of  the 
stomach,  a  distressing  anxiety  and  sense  of  oppression.  Gene- 
ral, and  often  extreme,  prostration.  Nausea,  faintness,  loud 
rumblings  in  the  bowels.  Sudden  and  forcible  vomiting  of 
a  milky  or  watery  fluid,  in  large  quantities.  Evacuations 
from  the  bowels,  consisting  of  a  similar  watery  substance, 
containing  white  floating  grains.  These  vomitings  and 
evacuations  are  attended  and  followed  by  spasms,  tremors, 
and  very  rapid  loss  of  the  heat  of  the  body.  The  skin  becomes 
cold,  clammy,  and  shriveled.  The  fingers  look  like  those  of 
a  washerwoman ;  the  skin  has  lost  its  elasticity,  and  if 
pinched  into  a  ridge  it  retains  that  form  for  a  long  time. 
There  is  often  great  thirst ;  but,  in  many  cases,  the  liquid 
is  no  sooner  swallowed  than  it  is  forcibly  ejected  from  the 
stomach.  The  extremities  are  frequently  the  seat  of  very 
painful  cramps. 

Severe  cases  pass  on,  in  the  course  of  eight  to  sixteen 
hours,  to  the  stage  of  COLLAPSE.  Indeed,  the  most  severe 
cases  may  almost  be  said  to  commence  with  collapse.  In  this 
condition  the  features  are  pinched  and  sunken ;  the  skin  is 
of  a  bluish  color,  icy  cold,  and  clammy;  the  tongue  is  cold, 
and  the  hands  are  corrugated.  The  voice  is  husky  and  faint, 
and  the  breath  is  cold.  The  pulse  is  frequent,  very  small, 
and  often  imperceptible.  The  evacuations  from  the  stomach 
and  bowels  become  less  and  less  frequent  as  this  stage 
becomes  more  fully  developed ;  and,  in  most  cases,  they 
entirely  cease  several  hours  before  death.  The  secretion  of 
urine  is  suspended.  The  thirst  is  intense.  The  external 


CHOLERA.  507 

surface  of  the  body  is  very  cold,  but  the  patients  complain 
of  an  internal  burning  heat. 

During  the  whole  course  of  the  disease  the  mind  is  clear 
and  composed.  It  is  very  remarkable  that,  although  fully 
aware  of  their  condition  and  danger,  the  majority  of  cholera 
patients  manifest  a  singular  apathy  and  indifference  with 
regard  to  the  result.  The  stage  of  collapse  may  last  from 
two  to  twelve  hours.  In  a  majority  of  cases  it  ends  in 
death.  In  the  more  fortunate  minority,  reaction  sets  in, 
marked  by  returning  warmth  and  re-established  secretions. 

It  is  to  be  noted  that  the  more  rapidly  fatal  the  case, 
the  earlier  the  collapse  occurs,  and  the  less  abundant  are 
the  evacuations.  In  the  most  terribly  rapid  cases,  which 
destroy  life  in  a  few  hours,  there  are  almost  no  evacuations. 
It  is  evident,  therefore,  that  death,  in  cholera,  does  not  come 
from  the  drain  on  the  system  resulting  from  the  evacuations, 
and,  consequently,  mere  astringent  remedies  will  not  cure 
cholera. 

During  an  epidemic  of  cholera,  diarrhoea  is  very  prevalent. 
It  almost  always  precedes  an  attack,  and  doubtless  predis- 
poses to  it.  '  Instant  attention  should  therefore  be  paid  to 
such  premonitions.  In  like  manner,  slight  cramps  are  often 
felt.  They  should  be  regarded  as  premonitions,  and  medi- 
cal advice  should  be  sought  at  once. 

The  mortality  of  cholera  has  been  very  uniform.  In 
1830-32,  on  the  continent  of  Europe  and  in  Great  Britain, 
the  deaths  in  private  practice  were  about  39 ^  Per  cent, 
of  the  cases;  in  hospital  practice  they  were  about  57*^ 
per  cent. 

In  Great  Britain,  there  occurred,  in  1831-33,  137,080 
cases  of  cholera,  of  which  52,547  died,  or  about  38^  per 
cent.  In  subsequent  epidemics  the  figures  have  been  about 
the  same.  From  the  official  returns  in  the  daily  newspapers 
o/  New- York,  in  1849,  it  appears,  that  in  this  city  there 
occurred,  in  a  period  of  fifty-two  days,  2,631  cases,  of 
which  915  died,  or  34.78  per  cent.  The  resident  physician 


508  CHOLERA. 

reported,  as  treated  in  the  hospitals,  i  ,02 1   cases  ;  of  which 
880,  or  53.71  per  cent,  died. 

These  facts  are  startling ;  but  they  are  nevertheless  facts. 
Instead  of  striving  to  avoid  and  ignore  them,  we  should 
calmly  accept  them  as  incentives  to  our  next  topic  :  The 
study  of  the  causes  which  favor  the  occurrence  and  increase 
the  malignity  of  epidemic  cholera. 
/ 

II. 

In  coming  to  consider  the  causes  which  favor  the  occur- 
rence and  spread  of  cholera,  and  increase  its  malignity, 
we  are  met  by  the  questions:  Is  cholera  contagious, — that 
is,  does  it  spread  by  touch  or  contact?  Or,  on  the  other 
hand,  does  it  exist  in  a  community  by  virtue  of  some  poison 
diffused  through  the  atmosphere,  and  to  which  all  persons 
in  'the  community  are  alike  exposed,  and  under  the  influence 
of  which  all  who  are  predisposed  to  the  disease  sicken, 
whether  they  had  been  previously  in  the  presence  of  cholera 
patients  or  not  ? 

The  ablest  minds  in  the  medical  profession  have  sought  to 
solve  these  questions  and  have  come  to  different  conclusions. 

In  favor  of  the  contagiousness  of  cholera,  its  general  line 
of  march  has  been  urged  as  an  argument.  It  followed 
established  routes  of  travel :  along  the  track  of  Eastern 
caravans;  from  Asia  to  Moscow  ;  thence  to  St.  Petersburg; 
thence  to  Berlin  and  Hamburg ;  from  Hamburg  on  board 
a  vessel  bound  to  England,  and  from  this  vessel  to  Sunder- 
land,  the  port  at  which  she  arrived;  from  Sunderland  through- 
out England. 

Again:  Professor  Simpson,  of  Edinburgh,  traced  cholera 
from  London,  by  a  vessel,  to  Leith,  where  the  sick  of  this 
vessel  were  placed  in  quarantine  on  a  hospital-ship.  The 
nurses  of  this  hospital-ship  were  attacked  with  the  disease, 
no  other  cases  of  it  having  as  yet  occurred  in  Scotland.  On 
shore,  it  first  assailed  persons  who  had  been  in  communi- 


CHOLERA.  509 

cation  with  the  sick  in  hospital.  In  this  manner  the  first 
six  cases  that  occurred  in  Scotland  were  traced  to  the  ship 
which  had  arrived  from  London,  where  cholera  was  pre- 
vailing, and  on  which,  during  her  voyage,  passengers  sick- 
ened of  cholera. 

In  the  same  way  Professor  Alison  traced  the  first  four 
cases  in  Edinburgh.  And  these  two  very  eminent  physi- 
cians had  no  doubt  of  the  contagiousness  of  cholera  in 
the  epidemic  in  question. 

So,  too,  Mr.  Moir,  of  Musselburg,  showed  that  the  first 
twenty-three  cases  of  cholera  in  Prestonpans  could  be  traced, 
by  an  unbroken  chain  of  contact  with  the  person  or  the 
clothing  of  cholera  patients,  back  to  a  first  case,  which  came, 
already  ill,  from  a  district  in  which  cholera  then  existed. 

During  the  first  epidemic  in  the  United  States,  a  vessel 
took  some  cases  to  Charleston,  S.  C.  They  were  strictly 
quarantined  under  military  guard.  Many  of  the  soldiers 
took  the  disease  and  died.  So  did  some  of  the  physicians 
and  nurses  who  were  sent  from  the  city  to  take  care  of  the 
sick.  But  not  a  case  occurred  in  the  city  nor  in  any  person 
who  had  not  been  in  contact  with  the  sick. 

Such  facts  as  these  can  hardly  be  explained  on  any  theory 
of  chances. 

On  the  other  side  of  the  question,  epidemics  of  cholera  are 
authentically  described,  in  which  the  spread  of  the  disease 
could  not  be  sufficiently  accounted  for  by  its  mere  con- 
tagiousness. An  English  commission,  sent  to  investigate 
this  very  question,  reported  that  in  Asia,  Turkey  and  Russia, 
the  history  of  cholera  precludes  the  idea  of  its  having  spread 
solely  by  contagion,  or  of  its  being  an  eminently  contagious 
disease.  Instances  are  adduced  of  its  invading  a  large 
district  or  city,  at  several  distant  points  simultaneously,  and 
of  its  attacking  so  many  persons  within  a  short  space  of  time 
that  the  doctrine  of  contagion  alone  would  be  inadequate  to 
explain  the  facts. 

The  strictest  quarantine  has  not  kept  out  the  disease ;  as, 


5IO  CHOLERA. 

for  example,  at  Moscow,  where,  to  no  purpose,  a  large 
garrison  preserved  around  the  city  a  prohibitive  cordon,  kept 
with  a  strictness  known  only  in  the  Russian  army. 

At  Charleston,  although  quarantine  kept  the  cholera  out 
in  1832,  it  was  of  no  avail  in  1833.  Though  it  seemed  to 
preserve  New- York  in  December,  1848,  yet  cholera  passed 
its  barriers  in  June,  1849. 

Finally,  it  has  been  observed  that,  in  some  places  and  at 
some  seasons,  although  cholera  has  been  introduced  and 
persons  have  been  exposed  to  its  infection,  yet  it  does 
not  extend — certainly  not  for  a  long  time.  This  was  the 
case  in  London  in  1831,  and  in  New- York  in  December, 
1848.  On  other  occasions  it  spreads  like  wild- fire,  as  at 
Paris,  in  1832,  where,  in  one  month,  it  carried  off  20,000 
persons. 

But  this  last  argument  is  not  conclusive  against  the  con- 
tagiousness of  cholera ;  for  the  same  apparent  reluctance  to 
extend  itself  was  observed  in  the  case  of  the  plague  (univer- 
sally regarded  as  contagious)  in  Cyprus,  1759.  It  has  been 
observed  of  small-pox  and  of  typhus  on  some  occasions. 

From  all  the  evidence  on  this  subject  we  may  conclude 
that,  while  in  certain  epidemics  cholera  has  undoubtedly 
been  introduced  and  propagated  by  contagion,  yet  the 
degree  of  contagiousness  of  the  disease  has  greatly  varied  in 
different  places,  at  different  times  and  under  different  cir- 
cumstances. We  think  that  "contagiousness  is  not  an  essen- 
tial attribute  "  of  this  (if  of  any)  disease  ;  "  it  is  an  accident, 
depending  upon  many  modifying  causes"  (Russell);  and 
that,  in  most  cases  of  disease  (cholera  as  well  as  other 
diseases),  the  question  is  not  so  much  one  of  kind  (contagious 
or  not  contagious)  as  rather  one  of  degree  (highly  contagious 
or  slightly  so). 

It  appears  that,  at  all  times,  there  have  been  requisite  for 
the  prevalence  of  cholera  in  a  community  a  peculiar  state  of 
the  atmosphere  and  peculiar  local  conditions.  And,  almost 
always,  those  who  are  attacked  by  cholera  are  found  to  have 


CHOLERA.  5  1 1 

been  previously  subjected  to  the  influence  of  certain  predis- 
posing causes. 

Admitting,  therefore,  the  importance  of  contagion  as  a 
means  of  conveying  the  seed  of  cholera,  we  perceive  that 
there  must  be  in  the  individual  in  whom  the  seed  is  planted 
a  congenial  soil ;  and  there  must  be,  likewise,  in  the  gen- 
eral conditions  of  atmosphere  and  mode  of  life  to  which 
that  individual  is  subjected  a  favorable  climate.  If  these 
be  lacking,  the  seed  will  not  germinate  and  bear  fruit  after 
its  kind. 

Let  us  inquire  what  conditions  constitute  this  favorable 
climate  and  congenial  soil ;  what  are  some  of  the  predispos- 
ing causes  of  cholera. 

1.  CLIMATE  AND  TOPOGRAPHY.     Hot  climates  and  the 
warm    season    of    the    year   predispose    to    cholera.       The 
epidemic,  of  1817  began  in  a  hot  summer  in  Hindostan.     In 
all  climates  the  disease  has  been  temporarily  checked,  if  not 
extinguished,  by  cold  weather.     The  apparent  exception  in 
Russia  is  explained  by  the  habits  of  the  Russian  people  — 
the  great  heat  and  the  extreme  filth  of  their  winter  habita- 
tions.    The  epidemic  of  the  past  autumn  in  France  seems 
to  have  been  checked  by  the  coming  on  of  cool  weather. 

Cholera  has  prevailed  most  severely,  though  not  exclu- 
sively, along  the  sea-coast  and  in  the  course  of  large  rivers, — 
more  particularly  where  the  land  is  low,  flat  and  swampy,  or 
imperfectly  drained.  The  low  "made  land"  of  commercial 
cities  is  its  favorite  feeding-ground.  In  this  cholera  resem- 
bles typhus  and  diphtheria. 

2.  HYGIENIC  CONDITIONS.     No  fact  is  better  established, 
and  none  is  more  important  to  be  widely  known,  than  this : 
That  wherever  FILTH  abounds  there  cholera  makes  itself  at 
home.     The  exhalations  from  an  undrained  soil,  saturated 
with    the   washings    of  uncleaned    streets;    an    atmosphere 
tainted  by  the  effluvia  from  accumulated  decaying  garbage 


512  CHOLERA. 

and  from  animal  and  human  excretions  —  these  furnish  a 
climate  in  which  the  seed  of  cholera  will  rapidly  develop  and 
grow  with  rank  luxuriance.  This  is  demonstrated  by  both 
positive  and  negative  evidence. 

In  London,  cholera  was  longest  prevalent  and  was  most 
deadly  in  the  uncleansed  and  overcrowded  tenement  houses. 
In  New- York,  in  1832,  it  began  in  Cherry  and  Roosevelt 
streets,  and  then  appeared  in  Reade,  Duane  and  Washing- 
ton streets.  It  raged  furiously  at  the  Five  Points,  in  the 
"rotten  row"  in  Laurens  street,  and  at  Corlaer's  Hook.  In 
1849  it  first  appeared  in  Baxter  street,  then  in  Mulberry 
street.  It  then  broke  out  in  Stanton  and  in  Thompson 
streets.  Whoever  is  familiar  with  these  localities  will  recog- 
nize in  their  names  the  synonyms  of  vegetable  decay  and 
animal  filth,  and  will  also  know  them  as  the  undrained  sites 
of  ancient  swamps  and  ponds,  the  water  of  which  still  stands, 
sending  up  vapors  through  their  oozy  soil.  See  General 
Viele's  recent  pamphlet  and  map,  "  The  Topography  and 
Hydrology  of  New- York." 

On  the  other  hand,  it  is  stated  on  good  authority  that  not 
a  single  case  of  cholera  occurred  in  any  of  the  new  "  Model 
Lodging  Houses "  of  London,  which  are  clean,  dry,  light 
and  well  ventilated,  and  which  are  not  allowed  to  be  over- 
crowded. In  1849,  m  Philadelphia,  which,  with  the  partial 
exception  of  two  districts,  was  prepared  for  cholera  by 
thorough  cleansing,  only  747  persons  died  of  that  disease, 
while  in  New- York  5,071  died  of  it.  Boston  was  still  more 
carefully  purified,  and  the  cholera  confined  itself  to  a  few 
narrow  lanes  and  crooked  streets  of  the  city. 

But  the  impure  air  that  favors  cholera  is  not  found  in 
filthy,  narrow  streets  alone.  It  may  exist  in  splendid  houses, 
upon  our  cleanest  and  broadest  avenues,  if  the  sewers  which 
drain  the  houses  be  defective,  clogged,  or  not  ventilated.  It 
may  exist  in  ANY  sick-room,  anywhere,  if  ventilation  and 
cleanliness  of  person  and  of  furniture  be  neglected. 


CHOLERA.  513 

3.  PERSONAL  HABITS.  It  is  universally  conceded  that  the 
free  use  of  alcoholic  drinks  predisposes  to  cholera.  It  should 
be  remembered,  however,  that  habitual  drunkards  are  also 
habitually  filthy,  and  irregular  in  their  habits,  and  are  often 
destitute.  Those  who,  having  previously  abstained  from 
liquor,  resort  to  its  free  use  for  the  purpose  of  warding  off 
cholera,  thereby  only  increase  their  liability  to  the  disease. 
On  the  other  hand,  those  who  are  habituated  to  the  moderate 
use  of  wine  run  a  risk  if  they  suddenly  discontinue  this  habit. 

Excesses  and  extremes  of  all  kinds  predispose  to  cholera. 
Excessive  filth  does  so.  So  does  excessive  bathing,  with  a 
view  to  extreme  cleanliness ;  for  it  reduces  the  heat  of  the 
body,  and  debilitates  the  system.  The  inordinate  use  of 
either  animal  or  vegetable  food  is  a  predisposing  cause. 
But  so,  'most  emphatically,  is  fasting  or  abstinence,  especially 
as  regards  animal  food.  The  excessive  mortality  from 
cholera  in  Paris,  which  we  have  mentioned,  occurred  during 
the  fastings  of  Lent.  Nothing  like  it  occurred  at  any  other 
period.  In  a  part  of  Louisiana,  where  nearly  all  the  people 
are  Papists,  the  mortality  during  a  cholera  epidemic  was 
quadrupled  during  and  after  a  three  days'  fast. 

Anything,  in  food  or  regimen,  that  irritates  the  bowels 
predisposes  to  cholera.  So  does  fatigue  or  violent  exercise. 
Reduction  of  the  temperature  of  the  body  by  exposure  to 
night  air  or  by  excessive  bathing  has  the  same  effect. 

But  the  most  powerful  of  all  predisposing  causes  are 
moral:  fear,  depressing  dread — PANIC!  We  should  strive 
against  this  in  every  way.  And  we  shall  be  most  likely  to 
avoid  panic  this  summer  if  we  now  faithfully  employ  every 
means  to  ward  off  the  disease  we  dread. 


III. 

From  a  study  of  the  history  and  the  predisposing  causes 
of  the  cholera,  we  turn  to  the  practical  questions:    How 
may  we  ward  off  the  disease  ?     Or  how,  if  it  come  among 
34 


514  CHOLERA. 

us,  may  we  circumscribe  its  extent  and  moderate  its  malig- 
nity ? 

Preventive  measures  may  be  collective,  undertaken  by  the 
state,  for  the  common  good ;  or  individual,  set  on  foot  by 
individuals,  or  single  families,  for  their  own  benefit 

QUARANTINE.  Do  its  advantages  compensate  for  the 
inconveniences  and  sufferings  to  individuals,  and  the  great 
losses,  by  restrictions  on  commerce,  which  it  involves  ? 

It  is  not  known  that  quarantine  regulations  have  ever 
protected  any  community  during  the  entire  course  of  any 
epidemic.  Yet,  on  the  other  hand,  there  is  abundant  evi- 
dence that  a  strict  quarantine  has  interposed,  for  a  time  at 
least,  an  effectual  bar  to  the  advance  of  the  disease,  thus 
postponing  its  visitations,  though  it  could  not  prevent  them. 
To  all  who  properly  value  human  life  above  convenience  in 
journeying  and  the  uninterrupted  flow  of  trade,  this  fact  is  a 
sufficient  argument  in  favor  of  a  strict  quarantine. 

Indirectly,  a  quarantine  may  operate  for  good  or  for  evil. 
For  good,  if,  while  it  postpones  the  invasion  of  cholera  for 
three  or  six  months,  it  nevertheless  warns  us  to  prepare  for 
its  inevitable  coming.  For  evil,  if,  by  its  temporary  success 
in  staying  the  pestilence,  it  deludes  us  into  fancying  that  the 
destroyer  will  pass  us  by,  and  that  we  need  take  no  care  to 
set  our  houses  and  cities  in  order  against  his  coming.  For, 
it  is  probable  that,  by  the  aid  of  a  rigid  quarantine,  we  gain 
the  advantage  of  ample  warning  and  of  time  to  adopt  the 
necessary  hygienic  measures  for  mitigating  the  severity  and 
circumscribing  the  extent  of  the  disease. 

The  chief  of  these  measures  is  the  removal  of  decaying 
organic  matter  from  our  houses  and  neighborhood.  Epi- 
demics of  cholera  have  been  very  aptly  called  "Providential 
admonitions  to  ' clean  up.'"  They  come  with  the  graduated 
severity  characteristic  of  Providential  warnings.  We  see 
them  far  off.  Their  approach  is  gradual.  At  last  they  come 
to  our  doors ;  and  there  their  advance  is  stayed  for  a  time 


CHOLERA.  515 

by  change  of  season  or  by  our  quarantine.  During  all  this 
time,  if  we  have  understood  the  warning,  we  may  have  been 
diligently  removing  from  our  midst  the  predisposing  causes 
of  the  disease.  In  proportion  to  our  promptness  in  taking 
warning,  and  to  our  diligent  faithfulness  in  preparing,  will  be 
the  gentleness  of  the  final  visitation.  When,  last  June,  we 
heard  of  cholera  in  Egypt,  we  should  have  begun  to  clean 
our  city.  Now  that  it  has  knocked  at  our  doors,  we  have 
still,  in  all  likelihood,  some  weeks  in  which  to  make  ready. 

Of  course,  our  streets  must  be  cleaned.  And  means 
should  be  taken  to  prevent  garbage  being  thrown  into  the 
streets.  Many  families  throw  refuse  into  the  streets, 
through  ignorance  and  carelessness.  A  friendly  word  in 
explanation  of  the  bad  consequences  that  result  from  it 
would  be  more  effective  in  preventing  it  than  a  city  ordi- 
nance. Every  citizen  may  make  it  his  duty  to  make  such 
representations  and  expostulations  to  his  delinquent  neigh- 
bors. In  so  doing  he  will  subserve  his  own  interests. 

But  the  greater  part  of  the  bad  air  of  our  houses  comes 
from  cess-pools  and  sewers.  Cess-pools  and  privy-vaults 
should  be  emptied  and  cleansed  during  the  cold  winter 
months.  Drains  leading  from  houses  to  cess-pools  or  sewers 
should  be  carefully  cleared,  and  all  traps  in  such  drains  or  in 
soil-pipes  should  be  opened  and  cleansed.  It  will  be  found 
in  many  instances,  that  traps  in  waste  and  soil  pipes,  and 
under  kitchen-sinks,  although  they  allow  water  to  pass,  are, 
nevertheless,  often  clogged  with  considerable  quantities  of 
most  offensive  matter. 

DRAINAGE.  Many  houses  in  New- York  and  its  suburbs 
stand  upon  "made  ground,"  which  is  not  properly  drained. 
The  cellars  and  surrounding  grounds  are  damp.  Such 
localities  should,  if  possible,  be  well  drained.  If  this  be 
impossible,  the  cellars  and  lower  stories  must  be  kept 
thoroughly  ventilated,  and  the  walls  and  cellar  floors  fre- 
quently whitewashed,  to  destroy  the  fungi  which  dampness 


5l6  CHOLERA. 

and  confined  air  develop.  It  must  not  be  forgotten  that 
ventilation  requires  provision  for  both  the  entrance  and  egress 
of  currents  of  air. 

VENTILATION.  Wherever  air  stagnates,  whether  in  cel- 
lars or  elsewhere  in  houses,  there  dampness  collects,  and  the 
lower  forms  of  vegetation  develop,  and  an  atmosphere 
results  which  predisposes  to  disease.  In  apartments  which 
are  constantly  occupied  by  human  beings,  the  exhalations 
accumulate  upon  the  walls  and  taint  the  atmosphere. 
Frequent  applications  of  whitewash  and  abundant  ventilation 
are  suitable  correctives.  These  remarks  apply  to  all  of  our 
residences,  and  not  merely  to  tenement  houses  and  out- 
buildings. 

DRINKING-WATER  is  often  made  impure  by  decaying 
vegetable  or  animal  matters,  and  is  then  a  fruitful  source  of 
disease.  Wells  dug  near  privies  or  cess-pools,  or  near  which 
drains  are  laid,  should  always  be  examined  with  reference  to 
this  fact. 

From  some  of  the  dangers  thus  far  enumerated  the  resi- 
dents of  New- York  are  exempt.  But,  to  a  greater  extent 
than  most  other  people,  they  are  endangered  by 

UNVENTILATED  SEWERS.  The  sewers  receive  the  refuse 
from  our  houses.  If  the  sewers  were  properly  constructed, 
this  refuse  would  never  stagnate  in  them.  But  even  so, 
decomposition  of  organic  matter  must  continually  go  on  in 
them,  evolving  noxious  gases.  To  prevent  these  gases 
from  flowing  back  into  the  houses  through  the  waste  and 
soil  pipes,  stench-traps  are  placed  in  these  pipes.  They 
consist  of  an  elbow  formed  in  the  pipe,  and  in  which  water 
remains,  constituting  a  barrier  to  the  backward  flow  of  the 
gases.  But  this  is  an  effective  barrier  only  so  long  as  the 
gases  are  subjected  to  no  upward  pressure.  If  the  gases  be 
subjected  to  such  pressure,  they  bubble  up  through  the 


CHOLERA.  517 

water  in  the  trap,   and   pass   into  the  house  through  the 
outlets  of  bath-tubs,  wash-basins,  and  closets. 

Now,  it  is  notorious  that  in  but  few  of  the  sewers  of  New- 
York  is  the  flow  of  matter  unimpeded.  No  provision  is 
made  for  the  outlet  of  gases  from  the  sewers.  The  gases 
accumulate,  and,  by  this  accumulation  and  by  the  heat 
evolved  in  their  generation,  they  become  subjected  to  press- 
ure. They  bubble  up  through  the  stench-trap,  and  pervade 
the  house.  Thus 

OUR  HOUSES  VENTILATE  OUR  SEWERS  !  Our  refuse  is 
discharged  into  the  sewers,  only  that  it  may  there  be  con- 
verted into  poisonous  gases,  and  be  received  again,  in  that 
form,  into  our  houses.  The  more  completely,  under  these 
circumstances,  a  house  is  provided  with  the  "  modern  con- 
veniences," the  more  deadly  a  habitation  it  is !  There  are 
houses  in  Fifth  avenue  and  in  Twenty- third  street  which  have 
illustrated  these  facts  by  the  sad  experience  of  their  inmates. 

In  many  houses  there  are,  besides  the  main  stench-trap 
already  described,  secondary  traps  under  each  basin,  closet, 
or  sink.  In  these  cases,  the  portion  of  pipe  intervening 
between  the  main  and  the  secondary  traps  becomes  a 
"closed  chamber,"  in  which  the  poisonous  gases  forced  up 
from  the  sewer  are  confined.  Any  increase  of  temperature, 
even  the  varying  heat  of  the  house,  will  expand  these  gases, 
and  cause  them  to  bubble  up  through  the  secondary  traps, 
and  into  the  house,  as  before. 

These  most  serious  dangers  may  be  obviated  by  ven- 
tilating the  sewers  or  the  waste-pipes.  The  latter  can  be  done 
for  himself  by  every  householder.  It  is  only  necessary  to 
connect  with  his  waste  or  soil  pipe,  just  below  the  uppermost 
trap,  a  small  pipe,  which  shall  be  led  up  through  the  roof, 
and  shall  open  into  the  atmosphere,  allowing  the  gases  to 
escape.  This  will  prevent  any  pressure  of  gas  below  the 
traps.  Personal  observation  and  experience  have  convinced 
us  of  the  great  value  of  this  ventilation  of  waste-pipes.  On 


518  CHOLERA. 

a  large  scale,  ventilation  of  sewers  in  English  towns  has 
reduced  the  mortality  from  typhus  to  one-half  its  former 
amount. 

It  should  be  noted  that,  as  many  of  the  predisposing 
causes  of  cholera  are  the  same  as  those  of  typhus  and  of 
diphtheria,  so  preventives  of  the  former  are  also  preventives 
of  the  latter  hardly  less  deadly  maladies. 

It  is  a  question  of  practical  importance  whether,  in  case  it 
has  been  impossible  to  empty  and  clean  cess-pools  and  vaults 
before  the  appearance  of  cholera,  it  would  be  safe  to  do  so 
after  the  disease  has  begun  to  prevail.  We  think  not.  It 
would  be  better  not  to  disturb  the  accumulation  of  organic 
matter.  But  we  may  intercept  the  gases  which  arise  from 
these  collections,  and  may  hold  them,  employing  for  this 
purpose  a  mixture  of  substances  which  chemically  unite  with 
the  gases  and  substances  which  mechanically  absorb  them; 
as,  for  example,  a  mixture  of  equal  parts  of  ground  plaster 
and  of  pulverized  charcoal  (or  coal  ashes)  with  the  addition 
of  one-eighth  part  of  copperas  (sulphate  of  iron).  This 
should  be  spread  upon  the  surface  of  the  contents  of  the  cess- 
pool or  privy- vault. 

As  regards  the  measures  to  be  adopted  by  individuals  to 
ward  off  cholera,  they  must  consist  mainly  in  the  avoidance 
of  those  things  which  have  been  specified  as  predisposing 
causes  of  the  disease. 

Excesses  of  all  kinds  are  to  be  avoided — excesses  of  absti- 
nence as  well  as  of  use. 

The  very  free  use  of  vegetable  food,  especially  of  the 
coarser  kinds. 

Indulgence  in  alcoholic  drinks. 

Exposure  to  night  air ;  to  cold  ;  to  undue  fatigue  of  any 
kind ;  to  mental  depression. 

But  it  would  be  unwise  to  make,  during  the  prevalence  of 
an  epidemic,  sudden  and  violent  changes  in  habits,  which, 
though  bad,  are  nevertheless  long-established  habits.  "It  is 
not  safe  to  trade  horses  when  crossing  a  stream." 


CHOLERA.  519 

IV. 

If,  in  spite  of  the  measures  by  which  we  had  hoped  to 
ward  it  off,  cholera  come  among  us  as  an  epidemic,  we  shall 
find  it  to  our  advantage  to  have  well  considered  beforehand, 
and  determined,  how  we  may  best  deal  with  it.  This  is  a 
question  for  each  individual  to  settle  for  himself,  since  the 
responsibility  is  his. 

The  obvious  answer,  as  indicating  the  wisest  course,  would 
be:  "I  will  seek  medical  advice."  But  it  is  all  important  to 
know  what  are  the  earliest  signs  that  medical  advice  is  needed. 

Dr.  Guerin,  in  his  elaborate  report  on  cholera  to  the 
French  Academy,  lays  great  stress  on  the  "fact"  that 
almost  every  case  of  decided  cholera  is  preceded  by,  what 
he  calls,  a  "  curable  stage ; "  a  period  during  which  the 
patient  suffers  from  a  diarrhoea,  or  some  other  derangement 
of  the  digestive  organs.  This  may  last  even  for  a  week  or 
ten  days.  It  is  often,  apparently,  so  slight  a  deviation  from 
health  that,  in  ordinary  times,  one  would  think  it  hardly 
necessary  to  consult  a  physician  or  take  remedies  for  it 
But  an  experienced  physician  would  at  once  recognize  it  as 
a  choleraic  diarrhoea — as,  in  fact,  cholera  in  the  preliminary, 
or,  as  Guerin  calls  it,  the  "curable  stage."  The  patient 
should  place  himself  under  medical  treatment  as  early  as 
possible  in  this  stage.  This  stage  cannot  be  so  described  as 
to  enable  a  non-medical  person  to  distinguish  it  with  cer- 
tainty from  a  common  diarrhoea.  Nor  is  it  possible  to  give 
such  directions  for  its  treatment  as  would  be  proper  for  a 
large  part  of  the  community,  without  modification  to  suit  the 
constitutional  peculiarities  of  each  individual. 

If  "  one  man's  meat  is  another  man's  poison,"  so,  much 
more  frequently,  is  his  medicine.  No  faith  should,  there- 
fore, be  placed  in  remedies  or  nostrums  that  are  offered 
as  "  sure  cures  "  for  everybody,  in  every  stage  of  cholera, 
etc.  Each  patient  requires  a  treatment  especially  adapted 
to  his  particular  constitution,  and  to  his  actual  condition. 


52O  CHOLERA. 

Many  persons  are  so  fortunate  as  to  have  a  medical 
adviser  who  commands  their  entire  confidence  ;  who  has 
attended  them  through  dangerous  illnesses,  has  studied 
and  appreciated  their  constitutional  peculiarities  and  tenden- 
cies, and  to  whose  care  they  would,  under  any  emergency, 
unhesitatingly  intrust  their  lives.  To  such  persons  no  better 
advice  can  be  given  than  this :  "  Consult  your  physician  ; 
be  advised  by  him  how  to  guard  against  cholera,  how  to 
meet  its  first  advances,  and  then,  resolving  to  follow  his 
counsels  implicitly,  go  about  your  business  with  an  easy 
mind."  But  many  are  not  thus  happily  situated.  They 
have  no  trusted  medical  adviser.  Even  now,  in  anticipation 
of  the  coming  of  cholera,  they  are  anxiously  looking  for  the 
soundest  medical  counsel,  and  for  that  system  of  medical 
treatment  which  offers,  in  its  statistics,  the  strongest  guar- 
antees of  success.  For  intelligent  members  of  the  com- 
munity well  know  that  there  are  radical  differences  in  the 
views  of  medical  men  as  regards  the  proper  and  the  most  suc- 
cessful treatment  of  cholera  as  well  as  of  all  other  diseases. 

It  were  a  foolish  affectation  to  ignore  these  differences. 
For  the  information,  therefore,  of  those  whose  minds  are 
not  settled,  but  who  are  in  quest  of  facts  on  the  subject 
of  these  differences  in  modes  of  medical  treatment,  I  will 
give  in  this  section  a  summary  of  the  statistics  of  the  treat- 
ment of  cholera  under  the  two  principal  antagonistic  systems 
of  medicine. 

As  might  naturally  be  supposed,  and  for  obvious  reasons, 
the  mortality  of  patients  treated  in  hospitals  is  always  much 
greater  than  that  of  patients  treated  at  their  own  houses. 

From  1831  to  1848  the  mortality  of  cholera  patients 
treated  by  the  ordinary,  "  regular,"  or  allopathic  treatment 
at  their  own  houses,  throughout  Europe,  was  one  in  two  and 
a  half  cases,  or  more  than  39  per  cent.  In  hospital  practice, 
during  the  same  period,  and  under  the  same  method,  the 
mortality  was  one  in  one  and  a  half  cases,  or  more  than 
57  per  cent. 


CHOLERA.  521 

During  the  same  period  the  mortality  of  patients  treated 
at  their  own  houses,  by  homoeopathic  physicians,  was  one 
death  in  eleven  cases,  or  a  little  more  than  9  per  cent. 

In  homoeopathic  hospitals,  the  mortality  was  one  in  three 
and  one-twelfth  cases,  or  a  little  more  than  33  per  cent. 

In  the  city  of  New- York  in  1832,  the  mortality  under 
allopathic  practice  was :  in  hospitals,  50  per  cent. ;  in  private 
practice,  33  per  cent. 

In  1849  the  mortality  under  allopathic  practice  was:  in 
hospitals,  53.7  per  cent.  ;  in  private  practice,  34.7  per  cent. 

During  this  epidemic  in  New- York,  the  aggregate  mor- 
tality under  homoeopathic  treatment,  under  many  disadvan- 
tages, was  15  per  cent. 

Summing  up  the  whole  number  of  patients  hitherto  re- 
ported as  treated  homceopathically,  in  Europe  and  America, 
both  in  private  and  in  hospital  practice,  we  find  a  mortality 
of  9  per  cent,  while  the  most  favorable  statement  of  mor- 
tality under  allopathic  treatment  is  32  per  cent. 

But  these  reports  of  the  results  of  homoeopathic  treatment 
have,  although  most  unjustly,  been  called  in  question.  It  is 
proper  to  authenticate  them  by  citing  the  action  of  govern- 
ment officials,  who  are  not  interested  in  the  disputes  of 
physicians,  and  by  quoting  the  words  of  distinguished  medi- 
cal men  who  are  not  homceopathists. 

Dr.  Gerstel,  of  Vienna,  and  Dr.  F.  F.  Quin,  now  a  vener- 
able and  distinguished  practitioner  in  London,  treated  cholera 
iin  Tischnowitz,  Moravia,  in  1831.  At  the  close  of  the 
epidemic,  a  report  was  made  to  the  Austrian  Government 
by  the  inspector.  It  concludes  as  follows  : 

"  The  proportion  of  deaths,  compared  with  other  places  in 
which  the  epidemic  raged,  was  small.  The  homoeopathic 
treatment,  which  was  carried  out  to  a  great  extent  by  Dr. 
cGerstel,  .was  .the  cause  of  this  favorable  result.  (Signed) 

DR.  VICTOR  MEKARSKY  VON  MERK, 

"  K.  K.  Inspector." 


522  CHOLERA. 

In  1836  cholera  visited  Vienna  a  second  time.  The  prac- 
tice of  Homoeopathy  was  at  that  time  forbidden  in  Austria, 
but  permission  was  obtained  to  open  a  Homoeopathic 
Cholera  Hospital.  I  state  the  result  in  the  words  of  Mr. 
Wilde,  of  Dublin,  the  distinguished  aural  and  ophthalmic 
surgeon,  who  is  no  friend  to  Homoeopathy.  He  says:1 

"  Upon  comparing  the  report  made  [by  the  government 
inspector,  who  visited  the  hospital  daily]  of  the  treatment  of 
cholera  in  this  hospital  with  that  of  the  same  epidemic  in  the 
other  hospitals  of  Vienna  at  a  similar  time,  it  appeared  that 
while  two-thirds  of  those  treated  by  Dr.  Fleischmann 
(homoeopathic)  recovered,  two-thirds  of  those  treated  by  the 
ordinary  methods,  in  other  hospitals,  died.  This  very  extra- 
ordinary result  led  Count  Kolowrat,  Minister  of  the  Interior, 
to  repeal  the  law  relative  to  the  practice  of  Homoeopathy." 

Thus  the  very  fact  that  the  practice  of  Homoeopathy  has 
been  sanctioned  by  law  in  Austria  since  1836,  is  an  eternal 
monument  and  testimony  to  the  superior  success  of  the 
homoeopathic  treatment  of  cholera. 

In  Paris,  in  1848-50,  Dr.  Tessier,  in  the  Hospital  St. 
Marguerite  (Hotel  Dieu,  annexe),  treated  cholera  patients  in 
his  wards  homoeopathically.  The  general  report,  made,  not 
by  Tessier,  but  by  allopathists,  gives  for  his  wards  a  mor- 
tality from  cholera  of  34^  per  cent.,  while  in  the  other 
wards  and  hospitals  the  mortality  was  5  7  per  cent. 

In  1854,  in  Great  Britain,  Government  established  a 
Medical  Council  to  gather  returns  of  the  treatment  and 
mortality  of  cholera  under  every  method,  and  to  report  to 
Parliament 

When  the  report  was  submitted  to  the  House  of  Com- 
mons, it  was  noticed  that  the  returns  of  the  homoeopathic  prac- 
titioners and  of  the  London  Homoeopathic  Hospital  were 
not  included  in  it.  The  House  of  Commons  thereupon  called 
for  these  rejected  returns,  and  they  were  presented  in  a  sepa- 
rate report,  entitled  "  Return  to  an  Address  of  Hon.  House 

1  Austria  and  its  Institutions,  p.  275. 


CHOLERA.  523 

of  Commons,  dated  May  17,  1855;  for  copies  of  any 
letters  ;  *  *  together  with  copies  of  any  returns  that  have 
been  rejected  by  the  Medical  Council." 

This  return  gives  the  statistics  of  the  London  Homoeo- 
pathic Hospital,  attested  by  Dr.  McLoughlin,  an  eminent 
allopathic  physician,  who  was  government  inspector  of 
cholera  hospitals,  by  appointment  of  the  same  medical 
council  which  rejected  the  returns  ! 

The  mortality  of  cholera  in  the  Homoeopathic  Hospital 
was  16.4  percent. 

Under  allopathic  treatment,  during  the  same  epidemic,  the 
Medical  Council's  return  to  Parliament  gives  the  mortality  as 
59.2  per  cent. 

In  a  public  letter  contained  in  the  report  of  the  Homoeo- 
pathic Hospital,  and  addressed  to  one  of  the  physicians  of 
this  hospital,  Dr.  McLoughlin,  Government  Inspector,  says  : l 

"  You  are  aware  that  I  went  to  your  hospital  prepossessed 
against  the  homoeopathic  system  ;  that  you  had  in  me,  in 
your  camp,  an  enemy,  rather  than  a  friend.  *  *  *  That  there 
may  be  no  misapprehension  about  the  cases  I  saw  in  your 
hospital,  I  will  add  that  all  I  saw  were  true  cases  of  cholera, 
in  the  various  stages  of  the  disease  ;  and  that  I  saw  several 
cases  which  did  well  under  your  treatment  which  I  have  no 
hesitation  in  saying  would  have  sunk  under  any  other. 

"  In  conclusion,  I  must  repeat  to  you  what  I  have  already 
told  you,  and  what  I  have  told  every  one  with  whom  I  have 
conversed,  that  although  an  allopath  by  principle,  education, 
and  practice,  yet,  was  it  the  will  of  Providence  to  afflict  me 
with  cholera,  and  to  deprive  me  of  the  power  of  prescribing 
for  myself,  I  would  rather  be  in  the  hands  of  a  homoeopathic 
than  an  allopathic  prescriber. 

"  I  cannot  suppose  that  anything  I  have  said  above  can  be 
of  value  to  the  homoeopathic  system ;  but,  such  as  it  is,  you 
are  at  full  liberty  to  make  what  use  you  please  of  this  letter 

"LONDON,  February  22,  1855." 

1  See  "  Return  to  House  of  Commons." 


524  CHOLERA. 

Let  it  be  remembered,  as  a  grand  result  of  statistics 
hitherto,  that  in  the  cholera  the  homoeopathic  treatment 
saves  91  in  100  cases;  allopathy  saves  never  more  than  68 
in  100  cases. 

These  are  facts,  and  they  are  re-assuring  facts  !  The  wise 
will  heed  them. 


V. 


The  homoeopathic  treatment  of  cholera,  as  of  every 
disease,  requires,  in  order  to  the  attainment  of  the  greatest 
success,  a  strict  individualization  of  cases,  and  a  special 
modification  of  the  treatment  to  meet  the  peculiarities  of 
each  case.  This  can  be  done  only  by  a  skillful  and  experi- 
enced homoeopathic  physician ;  and  no  general  directions 
for  treatment  can  be  published  which  will  give  the  best  possi- 
ble method  for  treating  each  person  attacked  with  cholera. 
Those,  therefore,  who  are  within  reach  of  a  physician,  should 
summon  him  at  the  earliest  moment.  The  following 
memoranda  are  offered  for  the  assistance  of  such  as  have  no 
physician  at  hand. 

The  subject  divides  itself  into  questions  of: 

1.  PROPHYLAXIS,  or  PREVENTION  of  CHOLERA. 

2.  TREATMENT  of  CHOLERINE,  or  PRELIMINARY  DIAR- 
RHOEA. 

3.  TREATMENT  OF  CHOLERA  PROPER. 

i.  PROPHYLAXIS.  The  fundamental  principle  of  the 
homoeopathic  practice  of  medicine  is  this :  that  a  sick 
person  is  to  be  treated  by  the  administration  of  a  drug 
which  has  been  found,  by  experience  or  observation,  to 
produce  upon  healthy  persons  symptoms  very  similar  to 
those  which  the  sick  person  presents. 


CHOLERA.  525 

In  accordance  with  this  great  principle,  it  is  clear  that  if 
the  symptoms  which  a  drug  produces  upon  healthy  persons 
are  known,  it  is  possible  to  foresee  and  to  foretell  what 
kinds  of  sickness  that  drug  will  cure. 

In  this  way,  long  before  cholera  had  invaded  Europe,  on 
its  first  westward  march,  Hahnemann,  having  become  ac- 
quainted with  the  action  of  these  drugs  upon  the  healthy, 
perceived  and  announced  that  Camphor,  Veratrum  album, 
and  Cuprum  metallicum,  would  be  the  most  efficacious 
remedies  for  cholera,  and  so  it  proved. 

A  similar  application  of  the  same  law  induced  Hahne- 
mann to  recommend  one  or  another  of  these  remedies 
(according  to  circumstances),  as  prophylactics,  or  prevent- 
ives of  cholera.  The  great  weight  of  testimony  compels  us 
to  believe  that  this  use  of  prophylactic  remedies  has  saved 
very  many  who  would  otherwise  have  been  attacked.  Dr. 
A.  Cricca,  of  Smyrna,  in  a  report  dated  September  28,. 
1865,  says  of  those  who,  under  his  directions,  used  the 
prophylactic  remedies :  "  Out  of  the  very  considerable 
number  of  persons  of  all  classes  and  conditions  (600  families 
or  about  3,000  individuals)  not  one  (to  our  knowledge)  has 
been  attacked  with  real  cholera.  Their  slight  derangements 
of  stomach  have  been  easily  cured  by  Veratrum  album." 

The  selection  of  the  prophylactic  remedy  must,  to  some 
extent,  be  governed  by  the  nature  of  the  epidemic,  and 
therefore  the  best  preventive  cannot  always  be  determined 
until  the  epidemic  has  appeared,  and  its  peculiar  nature  has 
been  ascertained. 

Cuprum.  But,  as  a  general  rule,  both  in  Europe  and  in 
this  country,  Cuprum  has  been  considered  the  most  efficient 
preventive.  A  dose  of  Cuprum  metallicum  should  be  taken 
every  third  day,  on  rising  in  the  morning.  It  was  noticed 
that  during  the  epidemic  of  1 849,  in  Paris,  workers  in  brass 
and  copper  escaped  the  disease. 

Sulphur.  In  some  epidemics,  Sulphur  has  been  the  best 
prophylactic.  It  will  be  suitable  if  the  diarrhoea  which 


526  CHOLERA. 

prevails  at  the  same  time  as  the  cholera,  and  the  diarrhoea 
which  precedes  many  cases  of  cholera,  be  of  the  character 
hereinafter  described,  as  indicating  Sulphur.  It  should  be 
taken  as  directed  for  Cuprum. 

2.  PRELIMINARY  DIARRHOEA.  It  has  been  stated  that 
almost  every  attack  of  cholera  is  preceded  by  a  diarrhoea, 
which  may  last  from  six  hours  to  six  days,  and  which,  if 
promptly  treated,  is  almost  always  easily  cured. 

During  the  prevalence  of  an  epidemic  of  cholera,  every 
diarrhoea,  however  slight,  should  be  regarded  as  being, 
possibly,  a  preliminary  to  an  attack  of  cholera,  and  should 
at  once  receive  careful  attention.  At  the  same  time,  it  is 
all-important  that  the  patient  should  not  give  himself  up  to 
fear  and  panic.  Let  him  use  his  utmost  self-control  to  keep 
his  mind  calm  and  his  faculties  clear,  so  that  he  may  be  able 
to  observe  his  own  condition  and  note  its  changes.  Every- 
thing should  be  done  quietly,  and  without  precipitate  haste. 
Prompt  attention  to  the  diarrhoea  is  advised,  not  so  much 
because  the  patient's  condition  is  already  a  perilous  one,  but 
rather  that  he  may  prevent  it  becoming  such. 

As  soon  as  diarrhoea  occurs,  the  patient  should  go  to  bed 
and  be  warmly  covered,  but  not  so  as  to  produce  perspira- 
tion. He  should  keep  the  recumbent  position  as  long  as 
diarrhoea  continues,  using  a  bed-pan  when  the  bowels  move. 
If  thirsty,  he  may  drink  cold  water,  but  in  moderate  quanti- 
ties. The  food  should  be  light,  but  nutritious,  and  taken 
frequently  in  small  quantities.  The  appropriate  remedy 
should  be  taken  without  delay. 

If  the  diarrhoea  come  on  in  the  night,  no  matter  how 
slight  it  may  be,  the  patient  should  immediately  call 
assistance,  or  begin  to  treat  it.  He  must  on  no  account 
wait  until  morning,  as  many  do,  thereby  losing  precious 
time. 

The  following  remedies  are  likely  to  be  suitable : 

Sulphur.     If  the  diarrhoea  comes  on  in  the  night,  after 


CHOLERA.  527 

midnight,  the  stools  being  yellow,  pappy,  and  attended  by 
great  urgency,  though  the  urging  is  often  ineffectual;  and 
if,  at  the  same  time,  there  are  cramps  in  the  soles  of  the 
feet,  Sulphur  should  be  taken,  a  dose  every  two  hours, 
until  relief  is  experienced.  It  is  a  general  rule  that  doses  of 
medicine  should  not  be  repeated  after  the  patient  has  begun 
to  improve,  nor  so  long  as  improvement  continues  to 
progress. 

Phosphoric  acid.  If  the  evacuations  are  light- colored, 
liquid,  copious,  and  not  attended  by  pain ;  if  the  tongue  is 
covered  with  a  gluey  mucus,  and  there  are  cramps  in  the 
arms,  with  a  general  sense  of  weakness,  Phosphoric  acid  is 
the  remedy.  Take  as  above. 

Arsenicum.  If  the  evacuations  are  frequent,  small  in 
quantity,  liquid,  dark-colored,  and  quite  offensive ;  attended 
by  sharp  pain  very  low  in  the  abdomen  and  by  burning  in 
the  rectum,  and  followed  by  great  prostration  of  strength ;  if, 
likewise,  the  patient  has  great  thirst,  drinking  but  little  at  a 
time,  and  is  very  restless  in  body  and  anxious  in  mind,  he 
should  take  Arsenicum,  as  directed  for  Sulphur. 

Croton  tiglium.  If  the  evacuations  are  sudden  and  very 
copious,  consisting  of  a  large  quantity  of  yellow  water, 
which  passes  with  a  rush,  and  if  an  evacuation  occurs  every 
time  the  patient  drinks,  Croton  tiglium  is  the  remedy.  Take 
as  directed  for  Sulphur. 

Veratrum  album.  If  the  diarrhoea  is  watery,  copious, 
and  very  painful,  and  is  accompanied  by  copious  vomiting, 
which  is  repeated  every  time  the  patient  drinks,  and  by  cold- 
ness and  blueness  of  face  and  hands,  and  cold  sweat  on  the 
forehead,  Veratrum  album  must  be  taken,  and  repeated 
every  fifteen  minutes  until  warmth  returns  and  water  can  be 
retained  on  the  stomach. 

3.  CHOLERA.  A  case  may  pass  gradually  from  choleraic 
diarrhoea  into  real  cholera;  or  a  neglected  diarrhoea  may 
apparently  cease  for  a  time,  and  then  cholera  may  suddenly 


528  CHOLERA. 

supervene ;  or  cholera  may  come  (it  rarely  does  so)  without 
warning. 

In  the  last  two  cases,  symptoms  resembling  those  already 
described  as  characterizing  COLLAPSE  are  present.  The 
patient  suddenly  loses  strength,  and  looks  pinched  and  blue. 
The  skin  becomes  very  cold  ;  the  voice  husky  and  deep ;  the 
skin  of  the  fingers  shrivels.  There  are  intense  distress  and 
anguish  at  the  pit  of  the  stomach  and  burning  in  the  bowels. 
The  patient  tosses  in  agony.  There  are  cramps  in  the  calves, 
and  sometimes  nausea  and  vomiting,  with  cold  sweat;  but, 
generally,  the  evacuations,  both  up  and  down,  are  moderate 
and  infrequent. 

Camphor.  This  is  the  form  of  the  disease  for  which 
Camphor  has  been  proved  to  be  so  excellent  a  remedy. 

In  addition  to  the  administration  of  Camphor,  the  patient's 
extremities  should  be  vigorously  rubbed,  and  bottles  of  hot 
water  applied  to  them  until  the  natural  heat  is  restored.  The 
room  should  be  well  ventilated,  and  cold  water  given  freely 
if  desired. 

Carbo  vegetabilis.  Sometimes  the  collapse  is  still  more 
marked.  Even  at  the  outset,  the  tongue  and  very  breath 
are  cold.  The  voice  is  extinct.  There  is  no  vomiting, 
diarrhcea,  spasm,  or  pain.  The  urine  is  suppressed.  Give 
Carbo  vegetabilis  every  five  minutes,  until  warmth  returns. 

Veratrum  album.  When  the  evacuations  are  profuse,  both 
upward  and  downward,  consisting  of  rice-water  and  frothy 
fluids,  with  great  anguish  in  the  abdomen,  thirst  for  cold  water, 
which  is  taken  in  large  quantities,  but  is  vomited  as  soon  as 
swallowed ;  with  contracted  features,  cold  sweat  on  the  fore- 
head, hands  and  feet,  moderate  cramps  in  hands,  feet  and 
calves;  with  suppression  of  urine, — Veratrum  album  should  be 
given  ;  a  dose  every  five  minutes  until  decided  improvement 
is  manifest. 

In  cases  requiring  Camphor  the  COLLAPSE  is  the  most 
prominent  feature.  In  those  which  require  Veratrum  album, 
the  EVACUATIONS  and  the  COLDNESS  are  the  most  promi- 


CHOLERA.  529 

nent  symptoms.     But  in  those  cases  which  call  for  Cuprum, 
the  SPASMS  or  CRAMPS  are  most  prominent. 

Cuprum  metallicum.  When  the  evacuations  are  not  very 
copious,  but  the  spasms  in  the  chest  and  stomach  are  very 
painful,  with  great  tenderness  to  touch,  the  spasms  coming 
on  in  paroxysms,  both  in  the  stomach  and  in  the  extremities ; 
the  thirst  is  moderate ;  the  vomiting  is  allayed,  for  a  time,  by 
drinking  water ;  the  face  is  blue  and  cold ;  the  respiration 
short  and  labored;  the  voice  husky;  and  the  urine  sup- 
pressed, give  Cuprum  metallicum  as  directed  for  Veratrum. 

ADMINISTRATION  OF  REMEDIES.  Where  medicines  in 
liquid  form  are  used,  a  drop  of  the  liquid,  on  sugar  or  in 
water,  may  be  used  as  a  dose ;  where  used  in  the  form  of 
powder,  as  much  as  would  lie  on  a  three-cent  piece ;  where 
globules,  three  or  four. 

Inconvenient  results  have  been  observed  from  the  use  of 
too  large  and  too  frequent  doses  of  Camphor ;  and  the  pub- 
lic should  be  cautioned  against  using  Camphor  without  a 
clear  indication  of  its  necessity.  Where  too  much  has  been 
taken,  it  produces  terrible  anguish  and  burning  at  the  pit  of 
the  stomach,  so  great  as  to  drive  the  sufferer  almost  to 
despair.  A  few  globules  of  Phosphorus  will  promptly  anti- 
dote the  Camphor  and  relieve  the  patient 


35 


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1877 

Dunham,  Carroll  1828-77 
Homeopathy  the  science  of  therapeutics 


